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General NPI Number Information
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NPI Number | 1104981208
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Entity Type | Individual
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Provider Name | STEWART RUSHTON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 1003 FRED LAGRONE DR
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City | CROSSETT
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State | AR
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Zip | 71635-4546
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Country | US
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Telephone | 870-364-3800
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Fax | 870-364-3811
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Provider Business Mailing Address
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Address Line | 1 STONE MOUNTAIN CT
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City | SKILLMAN
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State | NJ
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Zip | 08558-2377
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Country | US
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Telephone | 609-466-2016
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E1899
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License Number State | AR
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