Organization
RUSH MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BIRD (MANAGER)
(610) 334-5216
Entity
Organization
Contact information
Practice address
4540 AMBASSADOR CAFFERY PKWY, SUITE B-110, LAFAYETTE, LA 70508-6928
(337) 706-9073
Mailing address
4540 AMBASSADOR CAFFERY PKWY, SUITE B-110, LAFAYETTE, LA 70508-6928
(337) 706-9073
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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