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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