| Blue Ridge Medical Management Corporation | |
|
2000 Brookside Dr 3rd Floor Kingsport TN 37660-4627 | |
| (423) 857-5905 | |
| (423) 857-5904 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Hospitalist |
| Location | 2000 Brookside Dr, 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 2000 Brookside Dr 3rd Floor Kingsport TN 37660-4627 Ph: (423) 857-5905 | Blue Ridge Medical Management Corporation 2000 Brookside Dr 3rd Floor Kingsport TN 37660-4627 Ph: (423) 857-5905 |
| NPI Number | 1326086224 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 03/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326086224 | NPI | - | NPPES |
| CA5744 | Other | TN | RR MEDICARE |
| 7100115300 | Medicaid | KY | |
| 1326086224 | Medicaid | VA | |
| 3734243 | Medicaid | TN | |
| 5912640 | Medicaid | NC | |
| 020487805 | Other | TN | DEPARTMENT OF LABOR |
| 4344809 | Other | TN | BLUECARE |
| 7100031020 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (Tennessee) | Primary |
| 363L00000X | Nurse Practitioner | (Tennessee) | Secondary |
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 |