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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1073748539


NPI Information

NPI: 1073748539
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: MSMG GEN SURG ELIZ A

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1503 W ELK AVE
SUITE 8
ELIZABETHTON, TN
ZIP 37643
Phone: (423) 543-8619
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a specialist in Elizabethton, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1073748539. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Msmg Gen Surg Eliz A.

The provider's business location address is:

1503 W ELK AVE
SUITE 8
ELIZABETHTON, TN
ZIP 37643-876
Phone: (423) 543-8619
Fax: (423) 543-5133

The provider's authorized official is Carl Steven Kilgore .
The authorized official title is President and has the following contact phone number (423) 915-5100.

The enumeration date for this NPI number is 5/27/2009 and was last updated on 10/26/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13709285MEDICARE PINTENNESSEE
23377137MEDICARE PINTENNESSEE
31516167MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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