BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1659475374

NPI Information

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is an addiction medicine psychiatry neurology in Kingsport, TN. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1659475374. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dba Indian Path Pavilion.

The provider's business location address is:

2300 PAVILION DR
KINGSPORT, TN
ZIP 37660-622
Phone: (423) 392-5500
Fax: (423) 392-5597

The provider's authorized official is C. Steven Kilgore .
The authorized official title is Senior Vice President and has the following contact phone number (423) 915-5185.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 8/22/2020.

Taxonomy Codes

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