Booth, Jessica Leigh
Booth, Jessica Leigh is an individual health care provider with primary practice located at 1400 E Boulder St Ste 2508 , Colorado Springs CO 80909-5533. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Booth, Jessica Leigh can be contacted via phone (719) 365-6999.Contact Information
Primary practice address
1400 E Boulder St Ste 2508
Colorado Springs CO 80909-5533
Phone: (719) 365-6999
Fax: (719) 365-2837
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 2009-00757 | North Carolina |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 2009-00757 | North Carolina |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | DR.0059843 | Colorado |
Profile Details
| NPI number | 1710168398 |
|---|---|
| LBN Legal business name | Booth, Jessica Leigh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 24th, 2007 |
| Last updated | Mar 29th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710168398 | NPPES |
| North Carolina | MEDICAID | 5918755 | |
| North Carolina | MEDICAID | Q0075P | |
| North Carolina | MEDICAID | 1710168398 | |
| North Carolina | Other | 1710168398 | |
| North Carolina | MEDICAID | 3810022423 | |
| North Carolina | Other | P00948645 |
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