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Individual

DR. GEORGE R BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
307 S 13TH AVENUE, LAUREL, MS 39440
(601) 649-7600
(601) 649-7628
Mailing address
307 S 13TH AVENUE, LAUREL, MS 39440
(601) 649-7600
(601) 649-7628

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7631
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115394
MS
Enumeration date
07/11/2006
Last updated
07/08/2007
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