NPI 1295903565

Blue Ridge Medical Management Corporation

Organisation Pediatrics Physician Lebanon, VA

Practice location

Address: 344 Overlook Dr, Lebanon, VA 24266-3436
Phone: (276) 889-0201
Fax: (276) 889-0081
Mailing address: PO Box 3700, Johnson City, TN 37602-3700

Authorised official

Name: Carl Steven Kilgore
Title: President
Phone: (423) 915-5116

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X

Other Pediatrics providers in Virginia →

Registry record

NPI: 1295903565
Entity type: Organization
NPI issued: 20 Feb 2008
Record last updated: 29 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.