Healthcare Provider Details

I. General information

NPI: 1467156489
Provider Name (Legal Business Name): JOSHUA BUSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 E BROAD ST STE A
EUFAULA AL
36027-1710
US

IV. Provider business mailing address

617 E BROAD ST STE A
EUFAULA AL
36027-1710
US

V. Phone/Fax

Practice location:
  • Phone: 334-687-3836
  • Fax: 334-685-0725
Mailing address:
  • Phone: 334-687-3836
  • Fax: 334-685-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49375
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: