| Msmg Neuro Kpt | |
|
2212 N John B Dennis Hwy Suite C Kingsport TN 37660-5894 | |
| (423) 224-3940 | |
| (423) 224-3946 |
| Full Name | Msmg Neuro Kpt |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2212 N John B Dennis Hwy, Kingsport, Tennessee |
| Authorized Official Name and Position | Carl S Kilgore (PRESIDENT) |
| Authorized Official Contact | 4239155100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Msmg Neuro Kpt 2212 N John B Dennis Hwy Suite C Kingsport TN 37660-5894 Ph: (423) 224-3940 | Msmg Neuro Kpt 2212 N John B Dennis Hwy Suite C Kingsport TN 37660-5894 Ph: (423) 224-3940 |
| NPI Number | 1639441066 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639441066 | NPI | - | NPPES |
| 614862410 | Other | TN | DEPARTMENT OF LABOR |
| 1526970 | Medicaid | TN | |
| 1639441066 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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