MEDICARE: JAMES F BUSH MD

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
1	173000000X	Legal Medicine	25049	CO

General Provider Information

NPI Number	:	1437224649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES F BUSH MD

Provider Business Mailing Address
First Line	:	3817 LA MESA DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-9528
Country	:	US
Telephone Number	:	970-493-2447
Fax Number	:

Provider Business Practice Location Address
First Line	:	3817 LA MESA DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-9528
Country	:	US
Telephone Number	:	970-493-2447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/09/2007

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