Doctor Name: | MR. FORREST K BUSCH |
NPI Number: | 1063425791 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | DO0000000839 |
Business Practice Address: | 1950 Cook St Dyersburg, TN - 38024 |
Business Phone Number: | 7312864300 |
Business Fax Number: | 7312868008 |
Mailing Address: | 710 Hwy 51 Bypass, Pmb 363 DYERSBURG |
State: | TN |
Postal Code: | 38024 |
Phone Number: | 7312864300 |
Fax Number: | 7312868008 |
NPI Enumeration Date: | 08/14/2006 |
NPI Last Update Date: | 09/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | DO0000000839 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |