Individual
GLENN H BOOTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
3600 CHALMETTE CT, NASHVILLE, TN 37215-1001
(615) 327-0870
Mailing address
PO BOX 330969, NASHVILLE, TN 37203-7507
(615) 327-0870
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10421
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110000850
RAILROAD MEDICARE
TN
Enumeration date
10/03/2005
Last updated
04/05/2018
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