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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
MSMG Lebanon Family Practice, MSMG Rural Health Cliinic Lebanon
Organization subpart
No
Provider details
NPI number
Authorized official
CARL KILGORE (PRESIDENT)
(423) 915-5185
Entity
Organization
Contact information
Practice address
344 OVERLOOK DR STE 100, LEBANON, VA 24266-3436
(276) 883-8042
(276) 883-8044
Mailing address
58 CARROLL ST SUITE 3, DEPT OF RUSSELL COUNTY MEDICAL CENTER, LEBANON, VA 24266
(276) 883-8340
(276) 883-8341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/18/2016
Last updated
03/30/2026
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