Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG URO ABG A
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT/CEO)
(423) 915-5121
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 312D, ABINGDON, VA 24211-7664
(276) 783-5400
(276) 783-5521
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 312D, ABINGDON, VA 24211-7664
(276) 783-5400
(276) 783-5521
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033593249
—
VA
01
—
623323300
DEPARTMENT OF LABOR
VA
Enumeration date
07/17/2015
Last updated
02/14/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up