Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
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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