Individual
DR. THOMAS D BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20 13TH ST W, HAVRE, MT 59501-5215
(406) 265-7831
(406) 265-1651
Mailing address
PO BOX 1231, HAVRE, MT 59501-1231
(406) 262-1302
(406) 265-1651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4615
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015430
BLUE CROSS BLUE SHIELD
MT
05
—
0360893
—
MT
01
—
080096623
MEDICARE RAILROAD
MT
Enumeration date
02/07/2006
Last updated
11/30/2009
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