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1669488979
LISA C BUSHARDT
HATTIESBURG, MS
NPI
1669488979
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS 12307)
Enumeration Date
2006-07-31
Last Update Date
2020-07-08
Business Address
LISA C BUSHARDT MD
105 THORNHILL DR
HATTIESBURG, MS 39402-1548
Phone number: 601-261-3737
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Mailing Address
LISA C BUSHARDT MD
415 S 28TH AVE
HATTIESBURG, MS 39401-7246
Phone number: 601-261-3737
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