Organization
BLUE RIDGE MEDICAL MANGEMENT CORPORATION
Active
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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