Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG HIMA UCMH
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5100
Entity
Organization
Contact information
Practice address
100 GREENWAY CIR, ERWIN, TN 37650-2177
(423) 431-1810
(423) 431-1811
Mailing address
100 GREENWAY CIR, ERWIN, TN 37650-2177
(423) 431-1810
(423) 431-1811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912318635
—
VA
05
—
Q006137
—
TN
Enumeration date
05/15/2014
Last updated
12/03/2014
Update your record
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