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General NPI Number Information
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NPI Number | 1396073870
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Entity Type | Organization
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Legal Business Name | ADVANCED COMMUNITY CARE, PC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 415 BOONES CREEK RD STE 1
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City | JONESBOROUGH
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State | TN
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Zip | 37659-5111
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Country | US
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Telephone | 423-788-3455
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Fax | 423-788-0295
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Provider Business Mailing Address
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Address Line | 415 BOONES CREEK RD STE 1
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City | JONESBOROUGH
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State | TN
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Zip | 37659-5165
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Country | US
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Telephone | 423-788-3080
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Fax | 423-913-2810
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. RICHARD K MCDAVID
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Credential | MD
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Telephone | 423-788-3455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 38182
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License Number State | TN
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