Booth, Marc Alan

Booth, Marc Alan is an individual health care provider with primary practice located at 1225 E Coolspring Ave Ste 1-B , Michigan City IN 46360-6312. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Booth, Marc Alan can be contacted via phone (219) 879-6531.

Contact Information

Primary practice address
1225 E Coolspring Ave Ste 1-B Michigan City IN 46360-6312
Phone: (219) 879-6531
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01061093A Indiana
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 2023-00058 North Carolina

Profile Details

NPI number 1275515710
LBN Legal business name Booth, Marc Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Feb 13th, 2023 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1275515710 NPPES
Indiana MEDICAID 200527370

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