Individual
DR. LAWRENCE L BUSHKELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2018 WESTERN AVE, KNOXVILLE, TN 37921-5718
(865) 544-0406
(865) 544-0480
Mailing address
1923 SULPHUR SPRINGS RD, MORRISTOWN, TN 37813-5654
(423) 317-9344
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
13438
TN
207ND0101X
MOHS-Micrographic Surgery Physician
13438
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015500
BLUE CROSS
TN
05
—
3376258
—
TN
01
—
4034509
AETNA
TN
Enumeration date
05/03/2006
Last updated
12/11/2019
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