Individual
BRANDON DUBOSE BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(762) 235-2700
(706) 236-6437
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
061216
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
986418731A
—
GA
05
—
986418731B
—
GA
05
—
986418731C
—
GA
05
—
986418731D
—
GA
05
—
986418731E
—
GA
05
—
986418731F
—
GA
05
—
986418731G
—
GA
Enumeration date
05/01/2007
Last updated
03/23/2020
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