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Organization
BLUE RIDGE PSYCHIATRIC CONSULTANTS
Active
Organization
BLUE RIDGE PSYCHIATRIC CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B GLADSON M.D. (CEO)
(706) 258-2192
Entity
Organization
Contact information
Practice address
990 E MAIN ST, BLUE RIDGE, GA 30513-4565
(706) 258-2192
(706) 258-2193
Mailing address
990 E MAIN ST, BLUE RIDGE, GA 30513-4565
(706) 258-2192
(706) 258-2193
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
021506
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7043
MEDICARE GROUP NUMBER
GA
Enumeration date
11/05/2007
Last updated
11/21/2007
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