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Individual

RUSSELL G SCARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(800) 228-0249
(252) 222-3602
Mailing address
PO BOX 39, MOREHEAD CITY, NC 28557-0039
(800) 228-0249
(252) 222-3602

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD014365
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3003918
TN
01
4052744
BLUE CROSS
TN
Enumeration date
07/23/2008
Last updated
07/23/2008
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