Boothby, Michael H

Boothby, Michael H is an individual health care provider with primary practice located at 2901 Acme Brick Plz , Fort Worth TX 76109-4124. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Boothby, Michael H can be contacted via phone (817) 529-1900.

Contact Information

Primary practice address
2901 Acme Brick Plz Fort Worth TX 76109-4124
Phone: (817) 529-1900
Fax: (817) 529-1910
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X M1030 Texas

Profile Details

NPI number 1669419743
LBN Legal business name Boothby, Michael H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Oct 8th, 2020 - about 6 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 1669419743 NPPES
Texas Other P01010705 MEDICARE RAILROAD
Texas MEDICAID 182488002 MEDICARE RAILROAD
Texas Other 8V9720 MEDICARE RAILROAD

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