Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG OB GYN ABG
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5121
Entity
Organization
Contact information
Practice address
277 WHITE ST NE, ABINGDON, VA 24210-2913
(276) 628-4335
(276) 628-3195
Mailing address
277 WHITE ST NE, ABINGDON, VA 24210-2913
(276) 628-4335
(276) 628-3195
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124472691
—
VA
05
—
Q021743
—
TN
Enumeration date
04/20/2016
Last updated
02/14/2017
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