Individual
DR. JENKINS B BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 REGENCY PARK DR, MCDONOUGH, GA 30253-6649
(770) 506-4119
(770) 506-4145
Mailing address
105 REGENCY PARK DR, MCDONOUGH, GA 30253-6649
(770) 506-4119
(770) 506-4145
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
059048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285084989A
—
GA
05
—
285084989B
—
GA
05
—
285084989D
—
GA
05
—
285084989E
—
GA
05
—
285984989C
—
GA
Enumeration date
07/11/2006
Last updated
07/25/2016
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