Individual
GEORGE ANDREW BOUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 HOSPITAL DR, SUITE 1002, WATERTOWN, WI 53098-3331
(920) 261-8225
(920) 261-5343
Mailing address
123 HOSPITAL DR, SUITE 1002, WATERTOWN, WI 53098-3331
(920) 261-8225
(920) 261-5343
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
31275-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31675900
—
WI
Enumeration date
05/23/2005
Last updated
06/28/2012
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