Individual
MS. CASSIE LEE BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2961
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2016008383
MO
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
106898
MN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
56816
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
05
—
PENDING
—
MO
05
—
PENDING
—
OK
Enumeration date
04/13/2008
Last updated
06/16/2016
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