Healthcare Provider Details

I. General information

NPI: 1639663131
Provider Name (Legal Business Name): WILLIAM PATRICK ROUSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-5959
  • Fax: 334-528-5899
Mailing address:
  • Phone: 334-528-5959
  • Fax: 334-528-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD.51162
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: