MEDICARE: DR. ERIC L RUSHING M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	11772	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300064829	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891792842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC L RUSHING M.D.

Provider Business Mailing Address
First Line	:	1860 CHADWICK DR
Second Line	:	SUITE B
City	:	JACKSON
State	:	MS
Zip	:	39204-3463
Country	:	US
Telephone Number	:	601-373-6441
Fax Number	:	601-373-5715

Provider Business Practice Location Address
First Line	:	1860 CHADWICK DR
Second Line	:	SUITE B
City	:	JACKSON
State	:	MS
Zip	:	39204-3463
Country	:	US
Telephone Number	:	601-373-6441
Fax Number	:	601-373-5715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	03/22/2010

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Directions to “ DR. ERIC L RUSHING M.D.” Practice Location

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