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NPI Code Detail

MEDICARE: J BARRY BUSH, INC

MEDICARE: J BARRY BUSH, INC
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
1261Q00000XClinic/Center2939LA

General Provider Information

NPI Number : 1609042654
Entity Type Code : Organization
Provider Name (Legal Business Name) : J BARRY BUSH, INC
Provider Business Mailing Address
First Line : 415 N CUTTING AVE
Second Line :
City : JENNINGS
State : LA
Zip : 70546-5963
Country : US
Telephone Number : 337-824-4200
Fax Number : 337-824-4201
Provider Business Practice Location Address
First Line : 415 N CUTTING AVE
Second Line :
City : JENNINGS
State : LA
Zip : 70546-5963
Country : US
Telephone Number : 337-824-4200
Fax Number : 337-824-4201
Authorized Official
Title or Position : PRESIDENT
Name : MR. JAMES BARRY BUSH
Credential :
Telephone Number : 337-824-4200
Provider Enumeration Date : 04/30/2008
Last Update Date : 04/30/2008

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Directions to “J BARRY BUSH, INC ” Practice Location

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