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Individual

DR. JASON ADRIAN BOOTHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9615 KINCEY AVE STE 210, HUNTERSVILLE, NC 28078-9140
(704) 495-6334
Mailing address
5960 FAIRVIEW RD STE 500, CHARLOTTE, NC 28210-3113
(704) 495-6334

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2016-00166
NC
207QS1201X
Sleep Medicine (Family Medicine) Physician
2016-00166
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193050
RTL RESIDENT TRAINING LICENSE NUMBER
NC
01
2016-00166
NORTH CAROLINA MEDICAL BOARD
NC
Enumeration date
05/16/2013
Last updated
05/12/2026
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