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General NPI Number Information
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NPI Number | 1275738643
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Entity Type | Individual
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Provider Name | JULIE FORBUSH D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 131 OAK MEADOW DR STE 100
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City | PATASKALA
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State | OH
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Zip | 43062-9812
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Country | US
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Telephone | 614-483-3920
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Fax |
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Provider Business Mailing Address
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Address Line | 7626 WHITE CHAPEL RD
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City | NEWARK
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State | OH
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Zip | 43056-8054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01002202425
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.011876CTR
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License Number State | OH
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