Blue Ridge Medical Management Corporation

NPI #1568705457 in Erwin, Tennessee

Provider Information

NPI Number: 1568705457
Entity Type: Organization
Organization Name: Blue Ridge Medical Management Corporation
Primary Specialty: Family Medicine
Enumeration Date: Mar 29, 2013
Last Updated: Feb 14, 2017

Practice Location

Address: 630 ONEEGA LN
Address 2: SUITE A
City: Erwin
State: Tennessee
ZIP Code: 37650-2197
Phone: (423) 735-5700

Authorized Official

Name: CARL S KILGORE
Title: PRESIDENT
Phone: (423) 915-5121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Nurse Practitioner - Family — Family	363LF0000X
Family Medicine	207Q00000X	Primary

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