| Blue Ridge Medical Management Corpoartion | |
|
1980 Holton Ave E Ste 103 Big Stone Gap VA 24219-3367 | |
| (423) 302-3480 | |
| (423) 722-3009 |
| Full Name | Blue Ridge Medical Management Corpoartion |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1980 Holton Ave E Ste 103, Big Stone Gap, Virginia |
| Authorized Official Name and Position | Patricia Tarte (ENROLLMENT) |
| Authorized Official Contact | 4233026565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Medical Management Corpoartion 509 Med Tech Pkwy Ste 100 Johnson City TN 37604-2579 Ph: (423) 302-6565 | Blue Ridge Medical Management Corpoartion 1980 Holton Ave E Ste 103 Big Stone Gap VA 24219-3367 Ph: (423) 302-3480 |
| NPI Number | 1417683095 |
|---|---|
| Provider Enumeration Date | 07/27/2022 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417683095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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