Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG ORTHO MARION
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL STEVEN KILGORE (PRESIDENT/CEO)
(423) 915-5116
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, STE 100 C, ABINGDON, VA 24211-7664
(276) 258-1790
(276) 258-1795
Mailing address
16000 JOHNSTON MEMORIAL DR, STE 100 C, ABINGDON, VA 24211-7664
(276) 258-1790
(276) 258-1795
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659663342
—
VA
01
—
DF7910
RAILROAD MEDICARE
VA
Enumeration date
05/12/2011
Last updated
02/14/2017
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