Booth, Stacy B
Booth, Stacy B is an individual health care provider with primary practice located at 5 Mobile Infirmary Cir , Mobile AL 36607-3513. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Booth, Stacy B can be contacted via phone (251) 435-2646.Contact Information
Primary practice address
5 Mobile Infirmary Cir
Mobile AL 36607-3513
Phone: (251) 435-2646
Fax: (251) 435-6478
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA-472 | Alabama |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA.472 | Alabama |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | PA.472 | Alabama |
Profile Details
| NPI number | 1821002502 |
|---|---|
| LBN Legal business name | Booth, Stacy B |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Feb 3rd, 2011 - about 14 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 | 1821002502 | NPPES |
| Alabama | Other | 510-49995 | BCBS |
| Alabama | MEDICAID | 113211 | BCBS |
| Alabama | Other | 510-49993 | BCBS |
| Alabama | MEDICAID | 113213 | BCBS |
| Alabama | MEDICAID | 113243 | BCBS |
| Alabama | Other | 510-49994 | BCBS |
| Alabama | MEDICAID | 113209 | BCBS |
| Alabama | Other | 1821002502 | BCBS |
| Alabama | Other | 510-49992 | BCBS |
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