Individual
DR. SCOTT J TUSHLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2993 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4471
(719) 418-5505
Mailing address
4711 OPUS DR, COLORADO SPRINGS, CO 80906-8649
(719) 418-5505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0042737
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050394
BLUE CROSS
CA
01
—
951683892
OTHER INSURANCE
CA
05
—
RHM08608F
—
CA
05
—
ZZT40394F
—
CA
Enumeration date
01/17/2007
Last updated
02/04/2022
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