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General NPI Number Information
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NPI Number | 1730112475
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE FOOT AND ANKLE CLINIC PLC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 887A RIO EAST CT
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-8004
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Country | US
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Telephone | 434-979-8116
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Fax | 434-979-8880
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Provider Business Mailing Address
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Address Line | 887A RIO EAST CT
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-8004
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Country | US
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Telephone | 434-979-8116
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Fax | 434-979-8880
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN P MURRAY
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Credential | DPM
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Telephone | 434-979-8116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103000815
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103300932
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License Number State | VA
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