Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK W BOOKOUT, M.D.
ActiveOtolaryngology · EAST RIDGE, TN
Registration Details
- NPI Number
- 1356339063
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 7, 2005 (20.540815545993 yrs)
- Last Updated
- Dec 10, 2012
- Licenses
-
011511 (TN)025947 (GA)
Practice Information
- Address
-
4151 RINGGOLD RDEAST RIDGE, TN, 374122434Browse TN providers · Browse ZIP 37412
- Phone
- 4236225165
- Fax
- 4236225167
- Primary Specialty
-
Otolaryngology
207Y00000X
- Additional Specialty
- Otolaryngology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.