Provider Demographics
NPI:1346220704
Name:RUSHING, DYKES TAYLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:DYKES
Middle Name:TAYLOR
Last Name:RUSHING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:260 CHERRY DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3717
Mailing Address - Country:US
Mailing Address - Phone:828-262-0120
Mailing Address - Fax:
Practice Address - Street 1:STUDENT HEALTH, APPALACHIAN STATE UNIVERSITY
Practice Address - Street 2:614 HOWARD STREET, BOX 32070
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-0001
Practice Address - Country:US
Practice Address - Phone:828-262-3100
Practice Address - Fax:828-262-6262
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9700738208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG50995Medicare UPIN