Individual
JERRY L RUSHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 BARNHILL DR, #1300, INDIANAPOLIS, IN 46202
(317) 944-2801
(317) 944-5630
Mailing address
250 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46219-4959
(317) 963-2720
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01057495A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114380
—
IN
05
—
64065642
—
KY
Enumeration date
05/03/2006
Last updated
01/29/2021
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