Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG FP IM KPT
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5185
Entity
Organization
Contact information
Practice address
2202 N JOHN B DENNIS HWY, SUITE 204, KINGSPORT, TN 37660-5904
(423) 229-7777
(423) 229-7776
Mailing address
2202 N JOHN B DENNIS PKWY, SUITE 204, KINGSPORT, TN 37660-5887
(423) 229-7777
(423) 229-7776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3716296
—
TN
Enumeration date
04/09/2007
Last updated
03/31/2011
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