Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
Ballad Health Medical Associates, BHMA Pulmonology and Critical Care Abingdon, MSMG PULMONARY CRITICAL CARE JMH
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 212B, ABINGDON, VA 24211-7664
(276) 258-1740
(276) 258-1745
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 212B, ABINGDON, VA 24211-7664
(276) 258-1740
(276) 258-1745
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265813026
—
VA
01
—
622523600
DEPARTMENT OF LABOR
VA
01
—
DF7910
RR MEDICARE
VA
05
—
Q013970
—
TN
Enumeration date
06/17/2015
Last updated
03/29/2019
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