Booth Medical Center PC

NPI #1659448975 in Lagrange, Indiana

Provider Information

NPI Number: 1659448975
Entity Type: Organization
Organization Name: Booth Medical Center PC
Primary Specialty: Family Medicine
Enumeration Date: Nov 30, 2006
Last Updated: Jul 20, 2010

Practice Location

Address: 2600 N DETROIT ST
City: Lagrange
State: Indiana
ZIP Code: 46761-1154
Phone: (260) 463-4896

Authorized Official

Name: LISA N BOOTH, MD
Title: PHYSICIAN OWNER
Phone: (260) 463-4896

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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