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Individual
RICHARD BOOTH JR.
Active
Individual
RICHARD BOOTH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20669
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000235271
ANTHEM
WV
01
—
001709560
MT. STATE
WV
05
—
1083694970
—
WV
05
—
2342138
—
OH
05
—
64051667
—
KY
01
—
P00058440
RR MEDICARE
WV
Enumeration date
01/18/2006
Last updated
11/12/2020
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