Individual
RICHARD R BURDEAUX SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2545 JACKSBORO PIKE, JACKSBORO, TN 37757-4847
(423) 566-8181
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1037
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3303722
—
TN
01
—
P00060330
RR MEDICARE
TN
Enumeration date
06/19/2006
Last updated
07/17/2012
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