Healthcare Provider Details

I. General information

NPI: 1265064489
Provider Name (Legal Business Name): RICHARD PATTON MCCRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 2ND AVE E
ONEONTA AL
35121-2506
US

IV. Provider business mailing address

PO BOX 306491
NASHVILLE TN
37230-6491
US

V. Phone/Fax

Practice location:
  • Phone: 205-395-5014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-165002
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: