Basic Information
| Provider Information | |||||||||
| NPI: | 1851657803 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RUSH MEDICAL GROUP OF NEWTON, PA | ||||||||
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| OtherOrganizationName: | RUSH MEDICAL GROUP OF NEWTON-PHILADELPHIA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 309 | ||||||||
| Address2: | |||||||||
| City: | MERIDIAN | ||||||||
| State: | MS | ||||||||
| PostalCode: | 393020309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014852609 | ||||||||
| FaxNumber: | 6014847565 | ||||||||
| Practice Location | |||||||||
| Address1: | 1106 CENTRAL DR | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | MS | ||||||||
| PostalCode: | 393508972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014852609 | ||||||||
| FaxNumber: | 6014847565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2012 | ||||||||
| LastUpdateDate: | 03/01/2018 | ||||||||
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| AuthorizedOfficialLastName: | KENNEDY | ||||||||
| AuthorizedOfficialFirstName: | DON | ||||||||
| AuthorizedOfficialMiddleName: | LARKIN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6017039614 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.