Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG HOSP ORTHO JMH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL STEPHEN KILGORE (PRESIDENT)
(423) 915-5116
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 100 A, ABINGDON, VA 24211-7659
(276) 258-1790
(276) 258-1765
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 100 A, ABINGDON, VA 24211-7659
(276) 258-1790
(276) 258-1765
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073950499
—
VA
05
—
Q003480
—
TN
Enumeration date
05/24/2013
Last updated
04/09/2014
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