Provider Demographics
NPI:1205830056
Name:RUSHING, DONNA J (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:RUSHING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 E BERT KOUNS LOOP
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5634
Mailing Address - Country:US
Mailing Address - Phone:318-798-4488
Mailing Address - Fax:318-798-4420
Practice Address - Street 1:1455 E BERT KOUNS LOOP
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5634
Practice Address - Country:US
Practice Address - Phone:318-798-4488
Practice Address - Fax:318-798-4420
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017181207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00278939OtherRAILROAD MEDICARE NUMBER
LA1360988Medicaid
LA1053315846OtherGROUP NPI NUMBER
LA519616742Medicare PIN
LAP00278939OtherRAILROAD MEDICARE NUMBER
LAB63493Medicare UPIN