Carolyn M. Booth, PA

NPI #1033275631 in East Saint Louis, Illinois

Provider Information

NPI Number: 1033275631
Entity Type: Individual
Name: Carolyn M. Booth, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Dec 28, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 6000 BOND AVE
City: East Saint Louis
State: Illinois
ZIP Code: 62207-2328
Phone: (618) 332-2740

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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