Rushin, Jack Douglas
Rushin, Jack Douglas is an sole proprietor health care provider with primary practice located at 400 S 11Th St , Poplar Bluff MO 63901-5508. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Rushin, Jack Douglas can be contacted via phone (573) 785-5666.Contact Information
Primary practice address
400 S 11Th St
Poplar Bluff MO 63901-5508
Phone: (573) 785-5666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 004561 | Missouri |
Profile Details
| NPI number | 1093899940 |
|---|---|
| LBN Legal business name | Rushin, Jack Douglas |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jan 9th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093899940 | NPPES |
| Missouri | MEDICAID | 752079806 |
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