Organization · Type 2 NPI

Blue Ridge Medical Management Corporation

Addiction Medicine (Psychiatry & Neurology) Physician · Kingsport, TN

NPI number 1659475374 Active

Practice location

2300 Pavilion Dr
Kingsport, TN 37660-4622

Call (423) 392-5500 Map

Fax (423) 392-5597

Specialties and licenses

TaxonomyCodeLicense
Addiction Medicine (Psychiatry & Neurology) Physician Primary 2084A0401XNone listed
Psychiatry Physician 2084P0800XNone listed

Addiction Medicine (Psychiatry & Neurology) Physician: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

54 other providers at this address

About NPI 1659475374

Blue Ridge Medical Management Corporation's National Provider Identifier is 1659475374, issued on Sep 12, 2006. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Kingsport, TN. The record was last updated on Sep 11, 2025.