Individual
MICHAEL ANN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5764 NEW CALHOUN HWY NE, ROME, GA 30161-8252
(706) 295-4476
(706) 295-3018
Mailing address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3209
(706) 509-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002385
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002316A
—
GA
Enumeration date
06/10/2008
Last updated
11/06/2015
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