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Organization
RUSH MEDICAL FOUNDATION
Active
Organization
RUSH MEDICAL FOUNDATION
Active
Other names
Professional Services Division
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON LARKIN KENNEDY (REGIONAL CEO)
(601) 703-9614
Entity
Organization
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 483-0011
(601) 703-3080
Mailing address
DEPT 3024 P O BOX 1000, MEMPHIS, TN 38148-3024
(601) 213-3010
(601) 213-3011
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
2080P0202X
Pediatric Cardiology Physician
—
NULL
2080P0202X
Pediatric Cardiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009014336
—
MS
Enumeration date
03/29/2006
Last updated
12/28/2022
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