Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG Dermatology Abingdon, BHMA Dermatology Abingdon, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL STEPHEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
607 CAMPUS DR, ABINGDON, VA 24210-9700
(276) 619-2416
(276) 619-2418
Mailing address
607 CAMPUS DR, ABINGDON, VA 24210-9700
(276) 619-2416
(276) 619-2418
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF7910
RR MEDICARE
VA
Enumeration date
12/22/2014
Last updated
03/29/2019
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