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Organization

BLUE RIDGE MEDICAL MANGEMENT CORPORATION

Active
Other names
BHMA Vascular Surgery Johnson City, MSMG Vascular Surgery JC, Ballad Health Medical Associates
Organization subpart
No

Provider details

NPI number
Authorized official
CARL S. KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization

Contact information

Practice address
2 PROFESSIONAL PARK DR STE 11, JOHNSON CITY, TN 37604-6584
(423) 434-7400
(423) 434-7401
Mailing address
2 PROFESSIONAL PARK DR STE 11, JOHNSON CITY, TN 37604-6584
(423) 434-7400
(423) 434-7401

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary

Other

Enumeration date
09/13/2017
Last updated
07/21/2022
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