Provider Demographics
NPI:1457689069
Name:BOOTH, GARRETT SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:SCOTT
Last Name:BOOTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4650H THE VANDERBILT CLINIC
Practice Address - Street 2:1301 MEDICAL CENTER DRIVE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-936-8958
Practice Address - Fax:615-343-8420
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD47273207ZP0105X
TN47273207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology