Dr Audrey Kay Rutherford, MD is a medicare enrolled "Dermatology" physician in Centerville, Utah. Her current practice location is
1222 W Legacy Crossing Blvd Ste 200, Centerville, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 549-0570.
Dr Audrey Kay Rutherford is licensed to practice in Utah (license number 12829524-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366946899.
Physician's Profile
Full Name | Dr Audrey Kay Rutherford |
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Gender | Female |
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Speciality | Dermatology |
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Location | 1222 W Legacy Crossing Blvd Ste 200, Centerville, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1366946899
- Provider Enumeration Date: 03/20/2018
- Last Update Date: 09/29/2022
Medicare PECOS Information:
- PECOS PAC ID: 4385029230
- Enrollment ID: I20220914000728
Medical Identifiers
Medical identifiers for Dr Audrey Kay Rutherford such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366946899 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | 12829524-1205 (Utah) | 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. Dr Audrey Kay Rutherford is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Audrey Kay Rutherford, MD 114 Deer Creek Dr, Aledo, TX 76008-3900 Ph: (817) 304-8839 | Dr Audrey Kay Rutherford, MD 1222 W Legacy Crossing Blvd Ste 200, Centerville, UT 84014-5560 Ph: (801) 549-0570 |
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