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General NPI Number Information
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NPI Number | 1033485404
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Entity Type | Individual
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Provider Name | RUSLAN SAFAROV M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 420 W MORRIS BLVD STE 400D
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City | MORRISTOWN
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State | TN
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Zip | 37813-2282
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Country | US
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Telephone | 423-586-7509
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Fax | 423-581-5701
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Provider Business Mailing Address
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Address Line | 420 W MORRIS BLVD STE 400D
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City | MORRISTOWN
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State | TN
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Zip | 37813-2282
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Country | US
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Telephone | 423-586-7501
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 31386
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MD-45407
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME149074
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MD0000063618
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License Number State | TN
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