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NPI Code Detail

MEDICARE: RICHARD K MCDAVID M.D.

MEDICARE: RICHARD K MCDAVID M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician26551TN

General Provider Information

NPI Number : 1508861774
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD K MCDAVID M.D.
Provider Business Mailing Address
First Line : 3114 BROWNS MILL RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1417
Country : US
Telephone Number : 423-282-5611
Fax Number : 423-282-5712
Provider Business Practice Location Address
First Line : 3114 BROWNS MILL RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1417
Country : US
Telephone Number : 423-282-5611
Fax Number : 423-282-5712
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 07/08/2007

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