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General NPI Number Information
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NPI Number | 1902596877
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Entity Type | Organization
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Legal Business Name | ERIN RUSH ORTEGON, MD, LLC
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 6407 BARDSTOWN RD # 252
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City | LOUISVILLE
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State | KY
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Zip | 40291-3040
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Country | US
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Telephone | 502-435-1996
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Fax |
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Provider Business Mailing Address
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Address Line | 6407 BARDSTOWN RD # 252
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City | LOUISVILLE
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State | KY
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Zip | 40291-3040
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Country | US
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Telephone | 502-849-3709
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Fax | 832-336-3869
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | ERIN RUSH ORTEGON
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Credential | MD
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Telephone | 502-849-3709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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