| Blue Ridge Medical Management Corporation | |
|
444 Clinchfield St Suite 201b Kingsport TN 37660-3858 | |
| (423) 302-3135 | |
| (423) 230-0224 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 444 Clinchfield St, Kingsport, Tennessee |
| Authorized Official Name and Position | Carl Steven Kilgore (PRESIDENT) |
| Authorized Official Contact | 4233023051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Medical Management Corporation 444 Clinchfield St Suite 201b Kingsport TN 37660-3858 Ph: (423) 302-3135 | Blue Ridge Medical Management Corporation 444 Clinchfield St Suite 201b Kingsport TN 37660-3858 Ph: (423) 302-3135 |
| NPI Number | 1316328024 |
|---|---|
| Provider Enumeration Date | 06/18/2015 |
| Last Update Date | 03/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316328024 | NPI | - | NPPES |
| 1316328024 | Medicaid | VA | |
| Q013946 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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