Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG ORTHO ELIZ
Organization subpart
No
Provider details
NPI number
Authorized official
C STEVEN KILGORE (SENIOR VICE PRESIDENT)
(423) 915-5100
Entity
Organization
Contact information
Practice address
1503 W ELK AVE, SUITE 3, ELIZABETHTON, TN 37643-2876
(423) 542-3806
(423) 542-3814
Mailing address
1503 W ELK AVE, SUITE 3, ELIZABETHTON, TN 37643-2876
(423) 542-3806
(423) 542-3814
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3377133
—
TN
Enumeration date
08/09/2006
Last updated
10/26/2010
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