# BLUE RIDGE MEDICAL MANAGEMENT C ORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ballad Health Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295481869
- **Authorized official:** CARL KILGORE (VP)
- **Authorized official phone:** (423) 302-3051

## Contact information

- **Practice address:** 1420 TUSCULUM BLVD, GREENEVILLE, TN 37745-4279
- **Practice address phone:** (423) 787-5537
- **Practice address fax:** (423) 783-5579
- **Mailing address:** 509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
- **Mailing address phone:** (423) 302-6565
- **Mailing address fax:** (423) 952-2175

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2022
- **Last updated:** 12/12/2022