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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