Provider Demographics
NPI:1487858783
Name:MCADORY, RICHARD STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STEPHEN
Last Name:MCADORY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 PEGRAM DRIVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6319
Mailing Address - Country:US
Mailing Address - Phone:662-844-5344
Mailing Address - Fax:662-844-5363
Practice Address - Street 1:440 PEGRAM DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6319
Practice Address - Country:US
Practice Address - Phone:662-844-5344
Practice Address - Fax:662-844-5363
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21892208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty