Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Ridge Medical Management Corporation

Organization Addiction Medicine (Psychiatry & Neurology) Physician · NPI 1659475374

Blue Ridge Medical Management Corporation is an Addiction Medicine (Psychiatry & Neurology) Physician in Kingsport, Tennessee. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone: (423) 392-5500
Fax: (423) 392-5597
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Psychiatry & Neurology) Physician (primary) Taxonomy 2084A0401X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1659475374
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official C. Kilgore — Senior Vice President · (423) 915-5185
Other names Dba Indian Path Pavilion
NPI enumeratedSeptember 12, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address2300 Pavilion Dr, Kingsport, TN 37660-4622

Other providers in Kingsport