Booth, Caleb

Booth, Caleb is an individual health care provider with primary practice located at 1215 Lee St , Charlottesville VA 22908-0816. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Booth, Caleb can be contacted via phone (434) 924-9400.

Contact Information

Primary practice address
1215 Lee St Charlottesville VA 22908-0816
Phone: (434) 924-9400
Fax: (434) 982-1618
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110006158 Virginia

Profile Details

NPI number 1962947507
LBN Legal business name Booth, Caleb
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2017
Last updated Aug 2nd, 2021 - about 3 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 1962947507 NPPES
Virginia MEDICAID 1962947507

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