Booth, Holly Renee

Booth, Holly Renee is an individual health care provider with primary practice located at 1502 Cumberland Ave , Middlesboro KY 40965-1223. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Booth, Holly Renee can be contacted via phone (606) 248-0932.

Contact Information

Primary practice address
1502 Cumberland Ave Middlesboro KY 40965-1223
Phone: (606) 248-0932
Fax: (606) 248-1384
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1673DT Kentucky

Profile Details

NPI number 1194749473
LBN Legal business name Booth, Holly Renee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jul 16th, 2016 - about 9 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 1194749473 NPPES
Kentucky Other 1673DT STATE LICENSE NUMBER
Kentucky Other 1231987 STATE LICENSE NUMBER
Kentucky MEDICAID 010332605 STATE LICENSE NUMBER
Kentucky Other 134506 STATE LICENSE NUMBER
Kentucky Other 000000492097 STATE LICENSE NUMBER

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