Blue Ridge Medical Managment Corporation

NPI #1073990248 in Lebanon, Virginia

Provider Information

NPI Number: 1073990248
Entity Type: Organization
Organization Name: Blue Ridge Medical Managment Corporation
Primary Specialty: Internal Medicine
Enumeration Date: Apr 27, 2015
Last Updated: Mar 28, 2019

Practice Location

Address: 58 CARROLL ST
Address 2: ROOM 2037
City: Lebanon
State: Virginia
ZIP Code: 24266
Phone: (276) 883-8062

Authorized Official

Name: CARL STEVEN KILGORE
Title: PRESIDENT
Phone: (423) 302-3051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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