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Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG OB GYN ABG
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5121
Entity
Organization
Contact information
Practice address
277 WHITE ST NE, ABINGDON, VA 24210-2913
(276) 628-4335
(276) 628-3195
Mailing address
277 WHITE ST NE, ABINGDON, VA 24210-2913
(276) 628-4335
(276) 628-3195
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124472691
—
VA
05
—
Q021743
—
TN
Enumeration date
04/20/2016
Last updated
02/14/2017
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