Basic Information
Provider Information
NPI: 1801057203
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUSHING
FirstName: GREGORY
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ACKERMAN RD
Address2: SUITE 570
City: COLUMBUS
State: OH
PostalCode: 432021559
CountryCode: US
TelephoneNumber: 6142939327
FaxNumber: 6142932020
Practice Location
Address1: 452 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6142935502
FaxNumber: 6142937221
Other Information
ProviderEnumerationDate: 06/19/2008
LastUpdateDate: 02/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000X35099354OHY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

ID Information
IDTypeStateIssuerDescription
P0149372901OHRAILROAD MEDICAREOTHER
006875805OH MEDICAID


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