Individual
JOHN F BOOTHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
408 HAZEN ST, PAW PAW, MI 49079-1019
(269) 657-1325
(269) 657-1419
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN138136
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235131137
BCBSM
MI
Enumeration date
06/21/2006
Last updated
01/13/2010
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