Msmg Cvt Kpt

LBN: Blue Ridge Medical Management Corporation
Msmg Cvt Kpt is an health care organization with primary practice located at 2205 Pavilion Dr Suite 102, Kingsport TN 37660-4641. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is the primary health care specialty. Blue Ridge Medical Management Corporation can be contacted via phone (423) 929-7393, or through Kilgore, Carl Steven via phone (423) 915-5100.

Contact Information

Primary practice address
2205 Pavilion Dr Suite 102 Kingsport TN 37660-4641
Phone: (423) 929-7393
Fax: (423) 929-1427
Website:
Map and Directions
Authorized official contact:
Name: Kilgore, Carl Steven
Phone: (423) 915-5100

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1144458332
LBN Legal business name Blue Ridge Medical Management Corporation
DBA Doing business as Msmg Cvt Kpt
Authorized official Kilgore, Carl Steven
Entity Organization
Organization subpart 1 No
Enumeration date Jun 25th, 2009
Last updated Oct 27th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144458332 NPPES
Tennessee MEDICAID 1515098

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