George Andrew Boush, MD | |
123 Hospital Dr, Suite 1002, Watertown, WI 53098-3331 | |
(920) 261-8225 | |
(920) 261-5343 |
Full Name | George Andrew Boush |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Location | 123 Hospital Dr, Watertown, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053314070 | NPI | - | NPPES |
31675900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 31275-020 (Wisconsin) | Primary |
Entity Name | Watertown Physician Practices Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770964363 PECOS PAC ID: 8022329408 Enrollment ID: O20150626000114 |
Mailing Address | Practice Location Address |
---|---|
George Andrew Boush, MD 123 Hospital Dr, Suite 1002, Watertown, WI 53098-3331 Ph: (920) 261-8225 | George Andrew Boush, MD 123 Hospital Dr, Suite 1002, Watertown, WI 53098-3331 Ph: (920) 261-8225 |
Edward J Hoy, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Ste 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 | |
Holly C Van Hecke, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 123 Hospital Drive, Suite 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 | |
Sheila Kerri Sullivan, D.O. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 123 Hospital Drive, Suite 1002, Watertown, WI 53098 Phone: 920-261-8225 Fax: 920-261-5343 |