Individual
MR. KENNETH BRADLEY BUSH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3095 GOODMAN RD E, SOUTHAVEN, MS 38672-8707
(662) 536-3743
Mailing address
3588 EDGEWOOD BLVD W, HERNANDO, MS 38632-9383
(901) 896-8910
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
E-8208
MS
Other
Enumeration date
12/31/2019
Last updated
03/17/2020
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