Individual
DAVID G BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1301 VETERANS MEMORIAL BLVD, EUPORA, MS 39744-2064
(662) 258-7200
Mailing address
1301 VETERANS MEMORIAL BLVD, EUPORA, MS 39744-2064
(662) 258-7200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13719
MS
207Q00000X
Family Medicine Physician
Primary
2014-00095
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113548
—
MS
05
—
1093788523
—
NC
Enumeration date
02/07/2006
Last updated
09/15/2016
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