Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPOARTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA TARTE (ENROLLMENT SUPERVISOR)
(423) 302-6565
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-1121
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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