Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | N7411 | TX |
N | 208600000X | Surgeon | N7411 | TX |
Y | 2082S0105X | Plastic Hand Surgeon | 22944 | MS |
N | 2086S0122X | Plastic and Reconstructive Surgery | BP1-0026911 | TX |
NPI | 1740484302 |
---|---|
Provider Name | Dr. Carolyn Ann Cushing |
First Address | Madison, MS 39110-8772 |
Second Address | Flowood, MS 39232-9304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06906031 | (05) | MS |
175653 | (05) | AL |
2406418 | (05) | LA |
3872487469 | MYUTMB 3872487469-COMMERCIAL NUMBER (01) |