| Msmg Fp Im Kpt | |
|
2202 N John B Dennis Hwy Suite 204 Kingsport TN 37660-5904 | |
| (423) 229-7777 | |
| (423) 229-7776 |
| Full Name | Msmg Fp Im Kpt |
|---|---|
| Speciality | Internal Medicine |
| Location | 2202 N John B Dennis Hwy, Kingsport, Tennessee |
| Authorized Official Name and Position | Carl Steven Kilgore (PRESIDENT) |
| Authorized Official Contact | 4239155185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Msmg Fp Im Kpt 2202 N John B Dennis Pkwy Suite 204 Kingsport TN 37660-5887 Ph: (423) 229-7777 | Msmg Fp Im Kpt 2202 N John B Dennis Hwy Suite 204 Kingsport TN 37660-5904 Ph: (423) 229-7777 |
| NPI Number | 1467575001 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 03/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467575001 | NPI | - | NPPES |
| 3716296 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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