Joseph A Bushong, PA
Physician Assistant, Medical in Saint Louis, MO. Individual provider (NPI-1).
NPI number1386822013
StatusActive
Last updated in NPPESApr 3, 2024
Details
- NPI
- 1386822013
- Entity type
- Individual (NPI-1)
- Name
- Joseph A Bushong
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 5, 2008
- Certification date
- Apr 3, 2024
- Last updated
- Apr 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 2010015649 | MO | Yes |
Practice location
915 N Grand BlvdSaint Louis, MO 63106-1621
Phone 314-652-4100 · Fax 314-289-7694
Mailing address
915 N Grand BlvdSaint Louis, MO 63106-1621
Phone 314-289-6434 · Fax 314-289-7694
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