Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Heart and Vascular Clinchfield, MSMG CARDIOLOGY KPT A, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT/CEO)
(423) 302-3051
Entity
Organization
Contact information
Practice address
444 CLINCHFIELD ST, UNIT 201, KINGSPORT, TN 37660-3858
(423) 857-7650
(423) 857-7655
Mailing address
444 CLINCHFIELD ST, UNIT 201, KINGSPORT, TN 37660-3858
(423) 857-7650
(423) 857-7655
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205249885
—
VA
05
—
Q009978
—
TN
Enumeration date
06/11/2014
Last updated
03/29/2019
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