Healthcare Provider Details

I. General information

NPI: 1720009335
Provider Name (Legal Business Name): JOSEPH J BUSCH JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 GUNBARREL RD
CHATTANOOGA TN
37421-3125
US

IV. Provider business mailing address

1604 GUNBARREL RD
CHATTANOOGA TN
37421-3125
US

V. Phone/Fax

Practice location:
  • Phone: 423-893-7226
  • Fax: 423-893-7398
Mailing address:
  • Phone: 423-648-2395
  • Fax: 423-648-7542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number017780
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD9477
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: