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NPI Code Detail

MEDICARE: DR. MATT BUSSEY PHARMD

MEDICARE: DR. MATT BUSSEY PHARMD
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
1183500000XPharmacistPD11668AR

General Provider Information

NPI Number : 1659975365
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATT BUSSEY PHARMD
Provider Business Mailing Address
First Line : 2730 N WEST AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-3124
Country : US
Telephone Number : 870-862-6036
Fax Number :
Provider Business Practice Location Address
First Line : 2730 N WEST AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-3124
Country : US
Telephone Number : 870-862-6036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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