Individual
JASON BUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
120 HOSPITAL DR STE 100, LEBANON, MO 65536-9227
(417) 533-6751
Mailing address
120 HOSPITAL DR STE 100, LEBANON, MO 65536-9227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2024011270
MO
363A00000X
Physician Assistant
21247
CA
Other
Enumeration date
11/02/2010
Last updated
05/28/2024
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