MEDICARE: S EVERETT RUSHING, DMD,PA

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	OR376	MS

General Provider Information

NPI Number	:	1659462885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S EVERETT RUSHING, DMD,PA

Provider Business Mailing Address
First Line	:	749 CLINTON PKWY
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-5245
Country	:	US
Telephone Number	:	601-926-1772
Fax Number	:	601-926-1767

Provider Business Practice Location Address
First Line	:	749 CLINTON PKWY
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-5245
Country	:	US
Telephone Number	:	601-926-1772
Fax Number	:	601-926-1767

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EVERETT RUSHING
Credential	:	D.M.D.
Telephone Number	:	601-926-1772

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/22/2020

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