Healthcare Provider Details

I. General information

NPI: 1689316515
Provider Name (Legal Business Name): LOUIS BOOHAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 UNIVERSITY BLVD THT 215
BIRMINGHAM AL
35294-0001
US

IV. Provider business mailing address

1900 UNIVERSITY BLVD THT 229
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 256-404-7556
  • Fax:
Mailing address:
  • Phone: 256-404-7556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD.48224
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.48224
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number48224
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: