Healthcare Provider Details

I. General information

NPI: 1215146238
Provider Name (Legal Business Name): CYNTHIA B BOOKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2838 JEFF RD SUITE D
HARVEST AL
35749-8646
US

IV. Provider business mailing address

2838 JEFF RD SUITE D
HARVEST AL
35749-8646
US

V. Phone/Fax

Practice location:
  • Phone: 256-929-4185
  • Fax: 256-929-4188
Mailing address:
  • Phone: 256-929-4185
  • Fax: 256-929-4188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28646
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: