Organization
JEFFERY B BUSHMAN DO PC
Active
Organization
JEFFERY B BUSHMAN DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY BURL BUSHMAN D. O. (OWNER/PHYSICIAN)
(520) 384-4291
Entity
Organization
Contact information
Practice address
905 N BOWIE AVE, WILLCOX, AZ 85643-1145
(520) 384-4291
(520) 384-3055
Mailing address
PO BOX 1115, 905 N BOWIE AVE, WILLCOX, AZ 85644-1115
(520) 384-4291
(520) 384-3055
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2338
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277047
—
AZ
Enumeration date
11/10/2012
Last updated
11/10/2012
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