Organization
FORREST KENTON BUSCH, D.O. P.C.
Active
Other names
Dyersburg Skin Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE ANN HORNER (OFFICE MANAGER)
(731) 286-4300
Entity
Organization
Contact information
Practice address
1950 COOK ST, DYERSBURG, TN 38024
(731) 286-4300
(731) 286-8008
Mailing address
1950 COOK ST, DYERSBURG, TN 38024
(731) 286-4300
(731) 286-8008
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
DO0000000839
TN
207N00000X
Dermatology Physician
Primary
DO0000000839
TN
208D00000X
General Practice Physician
DO0000000839
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3303355
—
TN
Enumeration date
06/07/2007
Last updated
09/10/2015
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