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Individual

JOEL G BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2147 WILMA RUDOLPH BLVD, CLARKSVILLE, TN 37040-6663
(931) 245-8300
(931) 245-8360
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-8300
(931) 245-8360

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7520
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3156881
TN
Enumeration date
11/08/2005
Last updated
07/08/2007
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