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Organization
RUSH ORTHOPEDIC AND SPORTS MEDICINE
Active
Organization
RUSH ORTHOPEDIC AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAVUS A. RUSH III M.D. (OWNER)
(601) 703-9231
Entity
Organization
Contact information
Practice address
1800 12TH ST, SUITE 1C, MERIDIAN, MS 39301-4158
(601) 703-9231
(601) 703-4476
Mailing address
P.O. DRAWER 1930, MERIDIAN, MS 39302-1930
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209001400
US DEPT OF LABOR W/C
—
05
—
529917900
—
AL
01
—
DA7584
RAILROAD MEDICARE
—
Enumeration date
05/03/2006
Last updated
02/25/2011
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