Provider Demographics
NPI:1881019909
Name:BLUE RIDGE UROGYNECOLOGY, INC
Entity Type:Organization
Organization Name:BLUE RIDGE UROGYNECOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-480-9719
Mailing Address - Street 1:3800 ELECTRIC RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4569
Mailing Address - Country:US
Mailing Address - Phone:540-480-9719
Mailing Address - Fax:540-342-2193
Practice Address - Street 1:3800 ELECTRIC RD
Practice Address - Street 2:SUITE 405
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4569
Practice Address - Country:US
Practice Address - Phone:540-480-9719
Practice Address - Fax:540-342-2193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive SurgeryGroup - Single Specialty