Provider Demographics
NPI:1881159358
Name:BUSHBY, JOHN JOSEPH
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:BUSHBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 COUNTRY SIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9364
Mailing Address - Country:US
Mailing Address - Phone:740-348-5645
Mailing Address - Fax:
Practice Address - Street 1:5900 SHARON WOODS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2600
Practice Address - Country:US
Practice Address - Phone:614-487-8758
Practice Address - Fax:614-487-8759
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator