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NPI Code Detail

MEDICARE: DR. ROBERT L BOOTH JR. M.D.

MEDICARE: DR. ROBERT L BOOTH JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZH0000XHematology (Pathology) Physician35053764OH
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician35053764OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023016649
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT L BOOTH JR. M.D.
Provider Business Mailing Address
First Line : 3355 GLENDALE AVE FL 3
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2426
Country : US
Telephone Number : 419-383-3472
Fax Number : 419-383-6130
Provider Business Practice Location Address
First Line : 3000 ARLINGTON AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number : 419-383-3472
Fax Number : 419-383-6130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 01/29/2019

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Directions to “ DR. ROBERT L BOOTH JR. M.D.” Practice Location

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