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Organization

RIDGECREST MEDICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PRISCILLA MILLS (PRESIDENT)
(423) 353-1152
Entity
Organization

Contact information

Practice address
1907 W MORRIS BLVD, SUITE 300A, MORRISTOWN, TN 37813-3860
(423) 353-1152
(423) 353-1157
Mailing address
1907 W MORRIS BLVD, SUITE 300A, MORRISTOWN, TN 37813-3860
(423) 353-1152
(423) 353-1157

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
962
TN
207R00000X
Internal Medicine Physician
Primary
962
TN
208000000X
Pediatrics Physician
962
TN
363LF0000X
Family Nurse Practitioner
19037
TN

Other

Enumeration date
10/08/2014
Last updated
10/08/2014
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