Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG Infectious Disease ABG
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5100
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 313B, ABINGDON, VA 24211-7664
(276) 258-3770
(276) 258-3785
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 313B, ABINGDON, VA 24211-7664
(276) 258-3770
(276) 258-3785
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114308822
—
VA
01
—
622377400
DEPARTMENT OF LABOR
VA
05
—
Q013947
—
TN
Enumeration date
06/18/2015
Last updated
02/14/2017
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