NPI 1659020949 · live from the CMS NPI Registry
Mitchell Bryan Booth, DPM
Podiatrist, Foot & Ankle Surgery in Medford, OR. National Provider Identifier 1659020949, active.
NPI record
| NPI | 1659020949 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 1904 E Barnett Rd, Medford, OR 97504 |
| Practice phone | 541-776-3338 |
| Mailing address | 2307 W Joyli Cir, West Jordan, UT 84088 |
| Enumerated | March 22, 2022 |
| Last updated | June 2, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | DP224114 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.