Provider Demographics
NPI:1073518056
Name:FISHER, J RUSH JR (MD)
Entity type:Individual
Prefix:DR
First Name:J
Middle Name:RUSH
Last Name:FISHER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SPRUCE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5701
Mailing Address - Country:US
Mailing Address - Phone:215-662-3340
Mailing Address - Fax:
Practice Address - Street 1:801 SPRUCE ST STE 301
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5701
Practice Address - Country:US
Practice Address - Phone:215-662-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047419L207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2291465OtherAETNA HMO
DE2613OtherMID-ATLANTIC
DE5665641OtherAETNA PPO
DEG37821OtherCOVENTRY
DE0512017000OtherAMERIHEALTH/KEYSTONE
DE373895OtherINDEPENDENCE BC/PC
DE1000034633Medicaid
DE200040677OtherRAILROAD MEDICARE
DE5579793001OtherCIGNA
DE510399378OtherBCBS
DEG37821OtherCOVENTRY
DEG37821OtherCOVENTRY