Provider Demographics
NPI:1346212792
Name:BUSBEE, JONATHAN FRANK (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:FRANK
Last Name:BUSBEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-4141
Mailing Address - Country:US
Mailing Address - Phone:706-647-2147
Mailing Address - Fax:706-647-7229
Practice Address - Street 1:615 S CENTER ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-4141
Practice Address - Country:US
Practice Address - Phone:706-647-2147
Practice Address - Fax:706-647-7229
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00661328DMedicaid
GA11BDRGPMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
GA00661328DMedicaid