Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORAITON
Active
Other names
MSMG Wound Care JC, BHMA Wound Care JCMC, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CARL S KILGORE (PRESIDENT/CEO)
(423) 302-3051
Entity
Organization
Contact information
Practice address
408 N STATE OF FRANKLIN RD, STE 12, JOHNSON CITY, TN 37604-6089
(423) 431-2650
(423) 431-2659
Mailing address
408 N STATE OF FRANKLIN RD, STE 12, JOHNSON CITY, TN 37604-6089
(423) 431-2650
(423) 431-2659
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q022298
—
TN
Enumeration date
05/02/2016
Last updated
05/02/2025
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