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EDGAR ALAN BOONE M.D.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1568461002
Individual Registrant: EDGAR ALAN BOONE M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
200 WEST HOSPITAL DRIVE WHITERIVER, AZ 85941-0860 US
Tel: 928-338-4911 Fax: 928-338-5508
Tel: 928-338-4911 Fax: 928-338-5508
Contact information for business:
P.O.BOX 860 WHITERIVER, AZ 85941-0860 US
Tel: 928-338-4911 Fax: 928-338-5508
Tel: 928-338-4911 Fax: 928-338-5508
Registration Information:
NPI: 1568461002
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | PA | MD027914E |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 0010968930002 | PA | 05 | |
| AETNA | 0473267 | PA | 01 |
| HIGHMARK | 000067334 | PA | 01 |
| UPMC HEALTH PLAN | 104152 | PA | 01 |
| PALMETTO GBA RR MEDICARE | 010028191 | PA | 01 |
| WHITERIVER | 1427335140 | 01 | |
| UNITED MINE WORKERS | 1409575 | PA | 01 |
| CBQ | 1427335181 | 01 |
