Booth, Mallory A.
Booth, Mallory A. is an individual health care provider with primary practice located at 800 1St St Ste 410 , Macon GA 31201-8306. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Booth, Mallory A. can be contacted via phone (478) 743-7068.Contact Information
Primary practice address
800 1St St Ste 410
Macon GA 31201-8306
Phone: (478) 743-7068
Fax: (478) 741-1354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10676 | Georgia |
Profile Details
| NPI number | 1073960118 |
|---|---|
| LBN Legal business name | Booth, Mallory A. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2016 |
| Last updated | Jan 18th, 2022 - about 2 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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