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General NPI Number Information
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NPI Number | 1487035051
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Entity Type | Organization
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Legal Business Name | MIDTOWN PRIMARY CARE PLLC
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 11/25/2015
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Provider Practice Location Address
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Address Line | 2011 CHURCH ST SUITE 401
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City | NASHVILLE
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State | TN
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Zip | 37203-2000
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Country | US
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Telephone | 615-327-0870
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Fax | 615-327-0878
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Provider Business Mailing Address
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Address Line | 2011 CHURCH ST SUITE 401
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City | NASHVILLE
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State | TN
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Zip | 37203-2000
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Country | US
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Telephone | 615-327-0870
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Fax | 615-327-0878
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Authorized Official
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Title or Position | MD/OWNER
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Name | GLENN H BOOTH JR.
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Credential | MD
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Telephone | 615-327-0870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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