| Doctor Name: | MARK BOOHER |
| NPI Number: | 1023419363 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | B.S. |
| License Number: | |
| Business Practice Address: | 815 W 5th North St Morristown, TN - 378143810 |
| Business Phone Number: | 4235865032 |
| Business Fax Number: | 4235818473 |
| Mailing Address: | 6350 W Andrew Johnson Hwy, Department 100 TALBOTT |
| State: | TN |
| Postal Code: | 378778605 |
| Phone Number: | 8003553565 |
| Fax Number: | 4237142355 |
| NPI Enumeration Date: | 09/05/2014 |
| NPI Last Update Date: | 09/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Other |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |