Boothby, John A
Boothby, John A is an sole proprietor health care provider with primary practice located at 222 Auburn Street Suite 204, Portland ME 04103. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Boothby, John A can be contacted via phone (207) 874-0100.Contact Information
Primary practice address
222 Auburn Street Suite 204
Portland ME 04103
Phone: (207) 874-0100
Fax: (207) 874-8035
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 6217 | Maine |
Profile Details
| NPI number | 1457301467 |
|---|---|
| LBN Legal business name | Boothby, John A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Dec 31st, 2008 - about 16 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 | 1457301467 | NPPES |
| Maine | MEDICAID | 106100099 |
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