Albert Koy Booth III
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Albany, GA
NPI 1457566473 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457566473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- RN130702 (GA)
- Practice address
- 601 11TH Ave
Albany, GA 31701-1645 - Phone
- (229) 430-4140
- Fax
- (229) 430-4059
- NPI assigned
- May 12, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN130702 | GA | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN130702 | GA | Yes |
Addresses
Primary practice location
601 11TH Ave
Albany, GA 31701-1645
Mailing address
PO Box 1988
Albany, GA 31702-1988
Phone (229) 430-4005
Other providers in Albany, GA
- Amy Hendry Blueitt
- Mishondas Shantel Bogans
- Teresa Joy Bohlmeyer
- Jayne Bonner
- Britt A Boone
- Rebecc Mohl Borer
- Cheryl Boyett Botkin
- Salim Bou Slaiman
- Sidney Bowden
- Richard Lee Bowe
All providers in Albany, GA · Psychiatric/Mental Health Registered Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.