MEDICARE: DR. CAROLYN ANN CUSHING 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
1	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	22944	MS
2	208200000X	Plastic Surgery Physician	N7411	TX
3	2086S0122X	Plastic and Reconstructive Surgery Physician	BP1-0026911	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3872487469	OTHER	MYUTMB 3872487469-COMMERCIAL NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740484302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN ANN CUSHING M.D.

Provider Business Mailing Address
First Line	:	344 SUNDIAL RD
Second Line	:
City	:	MADISON
State	:	MS
Zip	:	39110-8772
Country	:	US
Telephone Number	:	512-796-8628
Fax Number	:

Provider Business Practice Location Address
First Line	:	281 TRACE COLONY PARK DR STE A
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-8810
Country	:	US
Telephone Number	:	601-345-1090
Fax Number	:	601-642-3272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	12/02/2025

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Directions to “ DR. CAROLYN ANN CUSHING M.D.” Practice Location

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