Booth, Ashlie Alexander
Booth, Ashlie Alexander is an sole proprietor health care provider with primary practice located at 1000 Towne Center Blvd Ste 604A , Pooler GA 31322-4052. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Booth, Ashlie Alexander can be contacted via phone (912) 450-4450.Contact Information
Primary practice address
1000 Towne Center Blvd Ste 604A
Pooler GA 31322-4052
Phone: (912) 450-4450
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | T2903 | Mississippi |
Profile Details
| NPI number | 1275860256 |
|---|---|
| LBN Legal business name | Booth, Ashlie Alexander |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 11th, 2009 |
| Last updated | Mar 29th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275860256 | NPPES |
| Mississippi | MEDICAID | 05903095 |
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