Msmg Fp Im Kpt

LBN: Blue Ridge Medical Management Corporation
Msmg Fp Im Kpt is an health care organization with primary practice located at 2202 N John B Dennis Hwy Suite 204, Kingsport TN 37660-5904. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Blue Ridge Medical Management Corporation can be contacted via phone (423) 229-7777, or through Kilgore, Carl Steven via phone (423) 915-5185.

Contact Information

Primary practice address
2202 N John B Dennis Hwy Suite 204 Kingsport TN 37660-5904
Phone: (423) 229-7777
Fax: (423) 229-7776
Website:
Map and Directions
Authorized official contact:
Name: Kilgore, Carl Steven
Phone: (423) 915-5185

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1467575001
LBN Legal business name Blue Ridge Medical Management Corporation
DBA Doing business as Msmg Fp Im Kpt
Authorized official Kilgore, Carl Steven
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2007
Last updated Mar 31st, 2011 - about 13 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 1467575001 NPPES
Tennessee MEDICAID 3716296

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