FRED WALLACE RUSHTON MD NPI 1194825323

NPI Information

NPI: 1194825323
Provider Name: FRED WALLACE RUSHTON, MD
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Address:
2500 N STATE ST
JACKSON, MS
ZIP 39216
Phone: (601) 925-6805
Get Directions

Fred Wallace Rushton, MD is a vascular surgery surgery in Jackson, MS. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Fred Wallace Rushton, MD NPI is 1194825323. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2500 N STATE ST
JACKSON, MS
ZIP 39216-500
Phone: (601) 925-6805
Fax: (601) 926-4978

The enumeration date for this NPI number is 9/25/2006 and was last updated on 4/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	06237	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	020000398	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI
2	512I770003	MEDICARE PIN	MISSISSIPPI
3	158101	MEDICAID	ALABAMA
4	302I775653	MEDICARE PIN	MISSISSIPPI
5	P00462318	OTHER	MISSISSIPPI	RR MEDICARE
6	B66038	MEDICARE UPIN	MISSISSIPPI
7	0013429	MEDICAID	MISSISSIPPI
8	020046786 GRPCG6446	OTHER	MISSISSIPPI	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »