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General NPI Number Information
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NPI Number | 1447552096
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE ORTHOPEDICS INC.
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 35 HOSPITAL RD STE 1
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3139
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Country | US
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Telephone | 706-439-6805
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Fax | 706-439-6806
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Provider Business Mailing Address
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Address Line | 35 HOSPITAL RD STE 1
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3139
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Country | US
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Telephone | 706-439-6805
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Fax | 706-439-6806
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS G. NUELLE
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Credential | M.D.
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Telephone | 706-439-6805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 48284
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License Number State | GA
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