Booth, Stacy B

Booth, Stacy B is an individual health care provider with primary practice located at 5 Mobile Infirmary Cir , Mobile AL 36607-3513. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Booth, Stacy B can be contacted via phone (251) 435-2646.

Contact Information

Primary practice address
5 Mobile Infirmary Cir Mobile AL 36607-3513
Phone: (251) 435-2646
Fax: (251) 435-6478
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-472 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.472 Alabama
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X PA.472 Alabama

Profile Details

NPI number 1821002502
LBN Legal business name Booth, Stacy B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Feb 3rd, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821002502 NPPES
Alabama Other 510-49995 BCBS
Alabama MEDICAID 113211 BCBS
Alabama Other 510-49993 BCBS
Alabama MEDICAID 113213 BCBS
Alabama MEDICAID 113243 BCBS
Alabama Other 510-49994 BCBS
Alabama MEDICAID 113209 BCBS
Alabama Other 1821002502 BCBS
Alabama Other 510-49992 BCBS

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