Provider Demographics
NPI:1487035051
Name:MIDTOWN PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:MIDTOWN PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-327-0870
Mailing Address - Street 1:2011 CHURCH ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2000
Mailing Address - Country:US
Mailing Address - Phone:615-327-0870
Mailing Address - Fax:615-327-0878
Practice Address - Street 1:2011 CHURCH ST
Practice Address - Street 2:SUITE 401
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2000
Practice Address - Country:US
Practice Address - Phone:615-327-0870
Practice Address - Fax:615-327-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty