Individual
DR. JAMES BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 936-2194
Mailing address
P.O. BOX 55589, JACKSON, MS 39216-0000
(601) 936-2194
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
08980
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018114
—
MS
01
—
1861428351
GROUP NPI
—
Enumeration date
07/29/2006
Last updated
08/25/2009
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