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NPI Code Detail

MEDICARE: DR. TIMOTHY AARON RUSH D.M.D.

MEDICARE:  DR. TIMOTHY AARON RUSH  D.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
11223G0001XGeneral Practice Dentistry6018KY

General Provider Information

NPI Number : 1467477737
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY AARON RUSH D.M.D.
Provider Business Mailing Address
First Line : 9605 FAIRMOUNT RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-3127
Country : US
Telephone Number : 502-239-5434
Fax Number : 502-538-9304
Provider Business Practice Location Address
First Line : 209 HIGH POINT CT STE 400
Second Line :
City : MT WASHINGTON
State : KY
Zip : 40047-6563
Country : US
Telephone Number : 502-538-4382
Fax Number : 502-538-9304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TIMOTHY AARON RUSH D.M.D.” Practice Location

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