Blue Ridge Medical Management Corporation

NPI #1629362033 in Abingdon, Virginia

Provider Information

NPI Number: 1629362033
Entity Type: Organization
Organization Name: Blue Ridge Medical Management Corporation
Primary Specialty: Urology
Enumeration Date: Jun 2, 2011
Last Updated: Jul 9, 2015

Practice Location

Address: 16000 JOHNSTON MEMORIAL DRIVE
Address 2: SUITE 112A
City: Abingdon
State: Virginia
ZIP Code: 24211
Phone: (276) 258-1740

Authorized Official

Name: CARL STEVEN KILGORE
Title: PRESIDENT
Phone: (423) 915-5116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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DR. Charles Douglas Daniel, M.D.	Urology	Roanoke	AI Deep Dive
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Eugene L Park, MD	Urology	Petersburg	AI Deep Dive

Organizations

Provider Name	Specialty	City
Blue Ridge Medical Management Corporation	Urology	Abingdon	AI Deep Dive
Urology Center of Southwest Virginia, Inc.	Urology	Abingdon	AI Deep Dive

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