# BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MSMG PULMONOLOGY of KINGSPORT A
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699188276
- **Authorized official:** CARL STEVEN KILGORE (PRESIDENT / CEO)
- **Authorized official phone:** (423) 915-5100

## Contact information

- **Practice address:** 444 CLINCHFIELD ST, UNIT 201A, KINGSPORT, TN 37660-3858
- **Practice address phone:** (423) 857-7650
- **Practice address fax:** (423) 857-7655
- **Mailing address:** 444 CLINCHFIELD ST, UNIT 201A, KINGSPORT, TN 37660-3858
- **Mailing address phone:** (423) 857-7650
- **Mailing address fax:** (423) 857-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2014
- **Last updated:** 02/14/2017