Individual
DR. ERIC THOMAS RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4419
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
2017013707
MO
207SG0201X
Clinical Genetics (M.D.) Physician
24664
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24664
NE STATE LICENSE
NE
Enumeration date
03/29/2007
Last updated
07/21/2022
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