Individual provider · NPI-1

Michael Ann Booth, PA

Physician Assistant · Rome, GA

NPI number1154581528
StatusActive
Last updated in NPPESNov 6, 2015

Details

NPI
1154581528
Entity type
Individual (NPI-1)
Name
Michael Ann Booth
Credential
PA
Sex
Female
Sole proprietor
No
Enumeration date
Jun 10, 2008
Last updated
Nov 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant002385GAYes

Practice location

5764 New Calhoun Hwy Ne
Rome, GA 30161-8252

Phone 706-295-4476 · Fax 706-295-3018

Mailing address

420 E 2nd Ave
Suite 103
Rome, GA 30161-3209

Phone 706-509-3000

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant providers in Rome, GA