Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
Regional Cancer Center at IPMC A
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5116
Entity
Organization
Contact information
Practice address
2002 BROOKSIDE DR, SUITE 300A, KINGSPORT, TN 37660-4634
(423) 232-6900
(423) 232-6903
Mailing address
2002 BROOKSIDE DR, SUITE 300A, KINGSPORT, TN 37660-4634
(423) 232-6900
(423) 232-6903
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516423
—
TN
Enumeration date
05/13/2013
Last updated
02/14/2017
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