# MOUNTAIN STATES HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MSMG Lebanon Family Practice, MSMG Rural Health Cliinic Lebanon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245781954
- **Authorized official:** CARL KILGORE (PRESIDENT)
- **Authorized official phone:** (423) 915-5185

## Contact information

- **Practice address:** 344 OVERLOOK DR STE 100, LEBANON, VA 24266-3436
- **Practice address phone:** (276) 883-8042
- **Practice address fax:** (276) 883-8044
- **Mailing address:** 58 CARROLL ST SUITE 3, DEPT OF RUSSELL COUNTY MEDICAL CENTER, LEBANON, VA 24266
- **Mailing address phone:** (276) 883-8340
- **Mailing address fax:** (276) 883-8341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2016
- **Last updated:** 03/30/2026