Boom, Alan D

Boom, Alan D is an individual health care provider with primary practice located at 1211 Union Ave Suite 300, Memphis TN 38104-6638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Boom, Alan D can be contacted via phone (901) 725-7551.

Contact Information

Primary practice address
1211 Union Ave Suite 300 Memphis TN 38104-6638
Phone: (901) 725-7551
Fax: (901) 725-9721
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 019703 Tennessee

Profile Details

NPI number 1265416333
LBN Legal business name Boom, Alan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Dec 27th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265416333 NPPES
Tennessee MEDICAID 3053894

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