Booth, Robert Douglas
Booth, Robert Douglas is an individual health care provider with primary practice located at 1265 Union Ave , Memphis TN 38104-3415. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Booth, Robert Douglas can be contacted via phone (901) 516-7600.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 6889 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1666 | Maine |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 399 | Arkansas |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA04555 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA04555 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA00081 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA1459 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1459 | Tennessee |
Profile Details
| NPI number | 1548377518 |
|---|---|
| LBN Legal business name | Booth, Robert Douglas |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Apr 19th, 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 | 1548377518 | NPPES |
| Texas | MEDICAID | 0 | |
| Texas | MEDICAID | 36650572 |
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