Provider Demographics
NPI:1205026952
Name:RUSHING, DENVER (OD)
Entity Type:Individual
Prefix:DR
First Name:DENVER
Middle Name:
Last Name:RUSHING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 N COMMERCE ST
Mailing Address - Street 2:STE, A
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1525
Mailing Address - Country:US
Mailing Address - Phone:580-223-5300
Mailing Address - Fax:580-223-5356
Practice Address - Street 1:1702 N COMMERCE ST
Practice Address - Street 2:STE, A
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1525
Practice Address - Country:US
Practice Address - Phone:580-223-5300
Practice Address - Fax:580-223-5356
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2542152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist