Individual
THOMAS C RUSHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 515, JACKSONVILLE, FL 32207-8207
(904) 396-4886
(904) 398-0496
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17822
WV
207RI0200X
Infectious Disease Physician
17822
WV
207RI0200X
Infectious Disease Physician
Primary
ME63732
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077233000
—
WV
05
—
0977448
—
OH
05
—
64700404
—
KY
Enumeration date
04/19/2006
Last updated
12/30/2020
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