Provider Demographics
NPI:1295858355
Name:RUSH, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:RUSH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 N MAIN ST
Mailing Address - Street 2:SUITE 232
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1180
Mailing Address - Country:US
Mailing Address - Phone:937-277-8988
Mailing Address - Fax:937-832-2421
Practice Address - Street 1:9000 N MAIN ST
Practice Address - Street 2:SUITE 232
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1180
Practice Address - Country:US
Practice Address - Phone:937-277-8988
Practice Address - Fax:937-832-2421
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2016-07-25
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Provider Licenses
StateLicense IDTaxonomies
OH35.088986207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2743544Medicaid
OHI73809Medicare UPIN
OHH091101Medicare PIN