Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
DBA Indian Path Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
C. STEVEN KILGORE (SENIOR VICE PRESIDENT)
(423) 915-5185
Entity
Organization
Contact information
Practice address
2000 BROOKSIDE DR, 7TH FLOOR GERIATRIC PSYCHIC UNIT, KINGSPORT, TN 37660-4627
(423) 857-7740
(423) 857-7711
Mailing address
2000 BROOKSIDE DR, 7TH FLOOR GERIATRIC PSYCHIC UNIT, KINGSPORT, TN 37660-4627
(423) 857-7740
(423) 857-7711
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3732722
—
TN
Enumeration date
09/13/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up