Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG IM MAR
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5116
Entity
Organization
Contact information
Practice address
1070 TERRACE DR, MARION, VA 24354-4138
(276) 781-2225
(276) 783-8843
Mailing address
1070 TERRACE DR, MARION, VA 24354-4138
(276) 781-2225
(276) 783-8843
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639459423
—
VA
01
—
DF7910
RAILROAD MEDICARE
VA
Enumeration date
08/24/2011
Last updated
02/14/2017
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