Provider Demographics
NPI:1457341018
Name:MCBRIDE, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MCBRIDE
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-602-6700
Mailing Address - Fax:865-602-6801
Practice Address - Street 1:900 E OAK HILL AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4522
Practice Address - Country:US
Practice Address - Phone:865-525-6688
Practice Address - Fax:865-525-0245
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38975207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519773Medicaid
TN103I066503Medicare PIN
TN1519773Medicaid
P00166195Medicare PIN
TN3896062Medicare PIN
TNG12932Medicare UPIN
TN103I060796Medicare PIN