Samuel Emile Rutherford, DR is a
Psychologist - Clinical based in Indianapolis, Indiana. Samuel Emile Rutherford is licensed to practice in Indiana (license number 20043782B) and his current practice location is
1481 W 10th St, Indianapolis, Indiana. He can be reached at his office (for appointments etc.) via phone at
(317) 544-0000.
NPI number for Samuel Emile Rutherford is 1477962173 and his current mailing address is 1255 Pearl St Ste 101, Eugene, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1477962173.
Healthcare Provider's Profile
| Full Name | Samuel Emile Rutherford |
|---|
| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 1481 W 10th St, Indianapolis, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1477962173
- Provider Enumeration Date: 08/06/2014
- Last Update Date: 08/19/2024
Medical Identifiers
Medical identifiers for Samuel Emile Rutherford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477962173 | NPI | - | NPPES |
| 500720412 | Medicaid | OR | |
| 500676126 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | T-16-097 (Oregon) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 20043782B (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Emile Rutherford is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Samuel Emile Rutherford, DR
1255 Pearl St Ste 101,
Eugene, OR 97401-3570
Ph: (541) 799-5386 | Samuel Emile Rutherford, DR
1481 W 10th St,
Indianapolis, IN 46202-2803
Ph: (317) 544-0000 |
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