Healthcare Provider Details

I. General information

NPI: 1427402106
Provider Name (Legal Business Name): CAMERON PHILIP BUSK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-5008
US

IV. Provider business mailing address

PO BOX 100186
GAINESVILLE FL
32610-5008
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-5911
  • Fax: 352-265-5606
Mailing address:
  • Phone: 352-265-5911
  • Fax: 352-265-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME157014
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number34757
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME157014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: