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General NPI Number Information
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NPI Number | 1437320272
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Entity Type | Organization
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Legal Business Name | CYNTHIA D. BOOTH, MD PLLC
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 120 E MAIN ST SUITE A
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City | PAYSON
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State | AZ
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Zip | 85541-5618
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Country | US
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Telephone | 928-474-9744
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Fax | 928-474-9766
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Provider Business Mailing Address
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Address Line | 120 E MAIN ST SUITE A
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City | PAYSON
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State | AZ
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Zip | 85541-5618
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Country | US
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Telephone | 928-474-9744
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Fax | 928-474-9766
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Authorized Official
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Title or Position | OWNER
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Name | DR. CYNTHIA D. BOOTH
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Credential | MD
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Telephone | 928-474-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 27365
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License Number State | AZ
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