Provider Demographics
NPI:1659441996
Name:CYRUS, RUSHELLE J (MEDICAL DOCTOR)
Entity Type:Individual
Prefix:MRS
First Name:RUSHELLE
Middle Name:J
Last Name:CYRUS
Suffix:
Gender:F
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W HOUSTON WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-6933
Mailing Address - Country:US
Mailing Address - Phone:901-679-5294
Mailing Address - Fax:901-679-5294
Practice Address - Street 1:2001 W HOUSTON WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-6933
Practice Address - Country:US
Practice Address - Phone:901-679-5294
Practice Address - Fax:901-679-5294
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000039386207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33327081OtherMEDICARE
I37189Medicare UPIN