Individual
TERRY W BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1310 S LEBANON ST # B, LEBANON, IN 46052-2792
(765) 482-0656
Mailing address
1310 S LEBANON ST # B, LEBANON, IN 46052-2792
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
02001138A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100341650
—
IN
Enumeration date
07/13/2005
Last updated
06/06/2022
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