Individual
DR. MARK E. RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 W ANTELOPE DR, LAYTON, UT 84041-1120
(801) 807-7140
(801) 807-7090
Mailing address
PO BOX 160354, CLEARFIELD, UT 84016-0354
(801) 774-8992
(801) 525-0347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
170833-1205
UT
207L00000X
Anesthesiology Physician
1708331205
UT
207LP2900X
Pain Medicine (Anesthesiology) Physician
1708331205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107018852101
SELECTHEALTH
UT
01
—
12600
UUHP
UT
01
—
17083312000001
BLUE CROSS
UT
01
—
170901
DMBA
UT
01
—
73000
PEHP
UT
01
—
QM0000030147
ALTIUS
UT
01
—
TPRA07445
MOLINA
UT
Enumeration date
05/22/2006
Last updated
09/11/2019
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