Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Parent organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Other names
Ballad Health Medical Associates, MSMG Beh Hlth JC - OP, BHMA Behaviroal Health Woodridge OP JC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Authorized official
MR. CARL S KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569
Mailing address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093120222
—
VA
05
—
Q013746
—
TN
Enumeration date
06/26/2014
Last updated
03/28/2019
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