| Organization Name: | BOOTHWYN MEDICAL ASSOCIATES P.C. |
| NPI Number: | 1699715086 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODNEY M. ELKIN (PHYSICIAN/PRESIDENT) |
| Mailing Address: | 1440 Conchester Hwy Suite 5a Boothwyn |
| State: | PA US |
| Postal Code: | 190612124 |
| Phone Number: | 6104593722 |
| Fax Number: | 6104594730 |
| NPI Enumeration Date: | 06/07/2006 |
| NPI Last Update Date: | 08/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | MD038926L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |