| Blue Ridge Family Practice Assoc | |
|
243 Jones Cove Rd Clyde NC 28721-9483 | |
| (828) 627-3411 | |
| (828) 627-6607 |
| Full Name | Blue Ridge Family Practice Assoc |
|---|---|
| Speciality | Family Medicine |
| Location | 243 Jones Cove Rd, Clyde, North Carolina |
| Authorized Official Name and Position | Donald R Teater (PRES CORP) |
| Authorized Official Contact | 8286273411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Family Practice Assoc 243 Jones Cove Rd Clyde NC 28721-9483 Ph: (828) 627-3411 | Blue Ridge Family Practice Assoc 243 Jones Cove Rd Clyde NC 28721-9483 Ph: (828) 627-3411 |
| NPI Number | 1932185204 |
|---|---|
| Provider Enumeration Date | 12/19/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932185204 | NPI | - | NPPES |
| 890137L | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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