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Individual

TOMMY RAY RUSHING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4300 W MAIN ST STE 102, DOTHAN, AL 36305-1306
(334) 793-9564
(334) 671-8907
Mailing address
PO BOX 6599, DOTHAN, AL 36302-6599
(334) 793-5000

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-138567
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-138567
ALABAMA LICENSE
AL
Enumeration date
08/31/2017
Last updated
12/17/2021
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