Boothby, Michael H
Boothby, Michael H is an individual health care provider with primary practice located at 2901 Acme Brick Plz , Fort Worth TX 76109-4124. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Boothby, Michael H can be contacted via phone (817) 529-1900.Contact Information
Primary practice address
2901 Acme Brick Plz
Fort Worth TX 76109-4124
Phone: (817) 529-1900
Fax: (817) 529-1910
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | M1030 | Texas |
Profile Details
| NPI number | 1669419743 |
|---|---|
| LBN Legal business name | Boothby, Michael H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Oct 8th, 2020 - about 5 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 | 1669419743 | NPPES |
| Texas | Other | P01010705 | MEDICARE RAILROAD |
| Texas | MEDICAID | 182488002 | MEDICARE RAILROAD |
| Texas | Other | 8V9720 | MEDICARE RAILROAD |
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