Dba Kingsport Internal Medicine

LBN: Blue Ridge Medical Management Corporation
Dba Kingsport Internal Medicine is an health care organization with primary practice located at 2205 Pavilion Dr , Kingsport TN 37660-4641. 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) 392-5010, or through Kilgore, C Steven via phone (423) 915-5185.

Contact Information

Primary practice address
2205 Pavilion Dr Kingsport TN 37660-4641
Phone: (423) 392-5010
Fax: (423) 392-5145
Website:
Map and Directions
Authorized official contact:
Name: Kilgore, C Steven
Phone: (423) 915-5185

Health care specialties

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

Profile Details

NPI number 1912910597
LBN Legal business name Blue Ridge Medical Management Corporation
DBA Doing business as Dba Kingsport Internal Medicine
Authorized official Kilgore, C Steven
Entity Organization
Organization subpart 1 No
Enumeration date Aug 14th, 2006
Last updated Aug 22nd, 2020 - about 5 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 1912910597 NPPES
Tennessee MEDICAID 3709286

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