Individual
JESSICA LEIGH BOOTH
Active
Individual
JESSICA LEIGH BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2009-00757
NC
207L00000X
Anesthesiology Physician
Primary
DR.0059843
CO
207LP2900X
Pain Medicine (Anesthesiology) Physician
2009-00757
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710168398
TRICARE
—
05
—
1710168398
—
VA
05
—
3810022423
—
WV
05
—
5918755
—
NC
01
—
P00948645
RAILROAD MEDICARE
—
05
—
Q0075P
—
SC
Enumeration date
11/24/2007
Last updated
03/29/2018
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