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NPI Code Detail

MEDICARE: DR. JANE ANNE RUSH FORD PSY.D., HSPP

MEDICARE: DR. JANE ANNE RUSH FORD PSY.D., HSPP
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
1103TC0700XClinical Psychologist20043443AIN
2103TM1800XIntellectual & Developmental Disabilities Psychologist20043443AIN
3103T00000XPsychologist

General Provider Information

NPI Number : 1578693156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANE ANNE RUSH FORD PSY.D., HSPP
Provider Business Mailing Address
First Line : 4740 KINGSWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1521
Country : US
Telephone Number : 317-466-1000
Fax Number : 317-466-2000
Provider Business Practice Location Address
First Line : 4740 KINGSWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1521
Country : US
Telephone Number : 317-466-1000
Fax Number : 317-466-1000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 04/30/2024

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