Individual
MR. FORREST K BUSCH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1950 COOK ST, DYERSBURG, TN 38024
(731) 286-4300
(731) 286-8008
Mailing address
710 HWY 51 BYPASS, PMB 363, DYERSBURG, TN 38024
(731) 286-4300
(731) 286-8008
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
DO0000000839
TN
207N00000X
Dermatology Physician
Primary
DO0000000839
TN
208D00000X
General Practice Physician
DO0000000839
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070009417
RAILROAD MEDICARE
TN
05
—
3303355
—
TN
Enumeration date
08/14/2006
Last updated
09/10/2015
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