Individual
SCOTT CASEY MCCUSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0848
(812) 801-0773
Mailing address
PO BOX 189, MADISON, IN 47250-0189
(812) 801-0848
(812) 801-0773
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01049529
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111701
ANTHEM BCBS
IN
01
—
1084621
PASSPORT KY MEDICAID
—
01
—
200034110
MEDICARE RAILROAD
—
05
—
200194530A
—
IN
01
—
2435685000
PASSPORT ADVANTAGE
KY
01
—
4082034
AETNA
—
01
—
410814P
SIHO
IN
05
—
64799604
—
KY
Enumeration date
07/02/2006
Last updated
04/23/2015
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