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General NPI Number Information
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NPI Number | 1376852673
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Entity Type | Organization
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Legal Business Name | APPALACHIAN EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 245 MEDICAL PARK DRIVE
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City | MARION
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State | VA
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Zip | 24354-6587
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Country | US
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Telephone | 276-782-1234
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Fax | 276-378-1105
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Provider Business Mailing Address
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Address Line | PO BOX 534964
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City | ATLANTA
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State | GA
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Zip | 30353-4950
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Country | US
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Telephone | 866-916-5259
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Fax | 231-922-4030
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Authorized Official
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Title or Position | PRESIDENT OF BLUE RIDGE MEDICAL MGT
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Name | CARL S KILGORE
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Credential |
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Telephone | 866-916-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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