Healthcare Provider Details

I. General information

NPI: 1790045375
Provider Name (Legal Business Name): NICHOLAS CHARLES RAUSH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 PICARDY AVE STE 313
BATON ROUGE LA
70809-3749
US

IV. Provider business mailing address

8585 PICARDY AVE STE 313
BATON ROUGE LA
70809-3749
US

V. Phone/Fax

Practice location:
  • Phone: 225-381-2755
  • Fax:
Mailing address:
  • Phone: 225-381-2755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number327388
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2018019499
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number327388
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number23937
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: