Provider Demographics
NPI:1902596877
Name:ERIN RUSH ORTEGON, MD, LLC
Entity Type:Organization
Organization Name:ERIN RUSH ORTEGON, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH ORTEGON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-849-3709
Mailing Address - Street 1:6407 BARDSTOWN RD # 252
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-3040
Mailing Address - Country:US
Mailing Address - Phone:502-849-3709
Mailing Address - Fax:832-336-3869
Practice Address - Street 1:6407 BARDSTOWN RD # 252
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3040
Practice Address - Country:US
Practice Address - Phone:502-435-1996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health