Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | N7483 | TX |
NPI | 1003046020 |
---|---|
Provider Name | Andrew Crighton Rutherford |
First Address | Dallas, TX 75243-6372 |
Second Address | Mesquite, TX 75149-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2009 |
Last Update Date | 04/12/2014 |