# MOUNTAIN STATES HEALTH ALLIANCE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DBA Russell County Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972771236
- **Authorized official:** C STEVEN KILGORE VI (PRESIDENT)
- **Authorized official phone:** (423) 915-5185

## Contact information

- **Practice address:** 58 CARROLL STREET, LEBANON, VA 24266
- **Practice address phone:** (276) 883-8471
- **Practice address fax:** (276) 883-8475
- **Mailing address:** PO BOX 3600, LEBANON, VA 24266-0200
- **Mailing address phone:** (276) 883-8471
- **Mailing address fax:** (276) 883-8475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 03/04/2008