Provider Demographics
NPI:1578454997
Name:BUSS, CAMERON ANDREW
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:ANDREW
Last Name:BUSS
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 1:268 PRITCHETT CV
Mailing Address - Street 2:
Mailing Address - City:MUNFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38058-5007
Mailing Address - Country:US
Mailing Address - Phone:731-377-0563
Mailing Address - Fax:
Practice Address - Street 1:620 MALL BLVD STE A
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-1649
Practice Address - Country:US
Practice Address - Phone:731-286-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist