Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory A. Booth, PA-C

Individual provider Medical Physician Assistant · NPI 1073960118

Mallory A. Booth, PA-C is a Physician Assistant in Tuscaloosa, Alabama. Qualified in 2014, 12 years ago. Practices with Southeastern Pain and Rehabilitation Physicians, PC, a 4-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1050 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2958
Phone: (478) 743-7068
Fax: (478) 741-1354
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10676 (GA)

Record details

NPI number1073960118
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 18, 2016
Last updated in NPPESJune 14, 2026
Certification dateJune 14, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Southeastern Pain And Rehabilitation Physicians, Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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