| Blue Ridge Medical Management Corporation | |
|
2204 Pavilion Dr Suite 310 Kingsport TN 37660-4653 | |
| (423) 224-3900 | |
| (423) 224-3901 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2204 Pavilion Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | Carl Steve 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 2204 Pavilion Dr Suite 310 Kingsport TN 37660-4653 Ph: (423) 224-3900 | Blue Ridge Medical Management Corporation 2204 Pavilion Dr Suite 310 Kingsport TN 37660-4653 Ph: (423) 224-3900 |
| NPI Number | 1730401209 |
|---|---|
| Provider Enumeration Date | 02/24/2010 |
| Last Update Date | 03/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730401209 | NPI | - | NPPES |
| CA5744 | Other | TN | RAILROAD MEDICARE |
| 1730401209 | Medicaid | VA | |
| 623293300 | Other | TN | DEPARTMENT OF LABOR |
| 3719388 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Wps Providers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-4000 | |
Sullivan And Ptrs Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2204 Pavilion Dr Ste 108, Kingsport, TN 37660 Phone: 423-392-6100 Fax: 423-392-0803 | |
Kingsport Primary Care, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1526 Bridgewater Ln, Kingsport, TN 37660 Phone: 423-246-0033 Fax: 423-245-0034 | |
Tri-cities Gastroenterology Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10461 Wallace Alley St, Kingsport, TN 37663 Phone: 423-279-1400 | |
Kingsport Consultants Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-4000 Fax: 423-224-4693 | |
Carl E Bendeck Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1328 Belmeade Dr, Kingsport, TN 37664 Phone: 423-578-3489 | |
A. Evan Lewis Phd Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1936 Brookside Dr Ste D, Kingsport, TN 37660 Phone: 423-392-5020 Fax: 423-392-5100 |