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NPI Code Detail

MEDICARE: DR. TOD RAYMOND BUSHMAN DPM

MEDICARE: DR. TOD RAYMOND BUSHMAN DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213EP1101XPrimary Podiatric Medicine PodiatristDPM 471TN
2213ES0103XFoot & Ankle Surgery PodiatristDPM 471TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26083425OTHERTNBCBS TN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417952581
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TOD RAYMOND BUSHMAN DPM
Provider Business Mailing Address
First Line : 410 42ND AVE N STE 400
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-3658
Country : US
Telephone Number : 615-292-5722
Fax Number : 615-346-6225
Provider Business Practice Location Address
First Line : 660 S MOUNT JULIET RD STE 230
Second Line :
City : MT JULIET
State : TN
Zip : 37122-3923
Country : US
Telephone Number : 615-874-9667
Fax Number : 615-871-9682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 10/18/2023

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Directions to “ DR. TOD RAYMOND BUSHMAN DPM” Practice Location

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