Provider Demographics
NPI:1356335079
Name:RUSHFORD, JAMES L (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:RUSHFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1100
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-1100
Mailing Address - Country:US
Mailing Address - Phone:417-257-6782
Mailing Address - Fax:417-257-5947
Practice Address - Street 1:1210 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2030
Practice Address - Country:US
Practice Address - Phone:417-256-1745
Practice Address - Fax:417-256-1746
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO730207X00000X
IL036120318207X00000X
MO2014031720207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR206111003Medicaid
TN3319268Medicaid
P00388661OtherRAILROAD MEDICARE PIN
MO1356335079Medicaid
TN3319269Medicaid
TN4146675OtherBLUE CROSS BLUE SHIELD TN
P00232183OtherRAILROAD MEDICARE
TN4146675OtherBLUE CROSS BLUE SHIELD TN
P00232183OtherRAILROAD MEDICARE
I29798Medicare UPIN