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Organization

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Active
Other names
MSMG NEUROSURG GR
Organization subpart
No

Provider details

NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5116
Entity
Organization

Contact information

Practice address
438 E VANN RD, SUITE 200, GREENEVILLE, TN 37743-7202
(423) 278-1704
(423) 278-1806
Mailing address
PO BOX 3700, JOHNSON CITY, TN 37602-3700
(866) 397-1439
(423) 262-1373

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3719387
TN
Enumeration date
08/31/2006
Last updated
10/29/2010
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