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1831109552
KENNETH EDWIN BOOTH
SHREVEPORT, LA
NPI
1831109552
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: LA md.015537)
Enumeration Date
2006-08-08
Last Update Date
2007-07-08
Business Address
Dr. KENNETH EDWIN BOOTH M.D.
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
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Mailing Address
Dr. KENNETH EDWIN BOOTH M.D.
10006 WINDING RIDGE DR
SHREVEPORT, LA 71106-7684
Phone number: 318-798-1254
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