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Organization

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Active
Other names
MSMG TRAUMA JC
Organization subpart
No

Provider details

NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5000
Entity
Organization

Contact information

Practice address
408 N STATE OF FRANKLIN RD, SUITE 31, JOHNSON CITY, TN 37604-6089
(423) 431-2477
(423) 431-2478
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 31, JOHNSON CITY, TN 37604-6089
(423) 431-2477
(423) 431-2478

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
10/24/2013
Last updated
10/24/2013
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