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Individual

TERRY STEVE MCCUISTON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
803 POPLAR ST, MURRAY, KY 42071-2432
(270) 762-1100
Mailing address
1160 A B LASSITER RD, MURRAY, KY 42071-4856

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29665
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000207499
BLUE CROSS BLUE SHIELD
KY
05
64296650
KY
01
P00233578
RAILROAD MEDICARE
KY
Enumeration date
05/22/2006
Last updated
07/08/2007
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