OrganizationActive
Blue Ridge Medical Management Corporation
NPI 1659475374 · Addiction Medicine (Psychiatry & Neurology) Physician · Kingsport, TN
Provider details
- NPI number
- 1659475374
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- C. Kilgore, Senior Vice President(423) 915-5185
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
Practice location
2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone: (423) 392-5500
Fax: (423) 392-5597
Approximate (ZIP-level) locationGet directions
Mailing address
2300 Pavilion Dr
Kingsport, TN 37660-4622
Other names (DBA / former)
- Doing business as
- Dba Indian Path Pavilion
Registry dates
- Enumerated
- 2006-09-12
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.