Provider Demographics
NPI:1407839517
Name:BUSCHE, JAMES P (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:BUSCHE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1307 ALBION AVE., STE. 102
Mailing Address - Street 2:ASSOCIATE OPTOMETRY, P.A.
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-1850
Mailing Address - Country:US
Mailing Address - Phone:507-238-4228
Mailing Address - Fax:507-238-4229
Practice Address - Street 1:1307 ALBION AVE., STE. 102
Practice Address - Street 2:ASSOCIATE OPTOMETRY, P.A.
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-1850
Practice Address - Country:US
Practice Address - Phone:507-238-4228
Practice Address - Fax:507-238-4229
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN0220152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0181060001OtherDMERC
MN0181060001OtherDMERC