Individual
RUSSELL CHARLES MCKISSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 MEDICAL CENTER PKWY, SUITE 200, MURFREESBORO, TN 37129
(615) 896-6800
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(615) 329-2294
(615) 695-1494
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
41837
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
41837
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000353
—
TN
Enumeration date
04/06/2007
Last updated
07/09/2025
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