Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Infectious Disease Kingsport, Ballad Health Medical Associates, MSMG Infectious Disease KPT
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
444 CLINCHFIELD ST, SUITE 201B, KINGSPORT, TN 37660-3858
(423) 302-3135
(423) 230-0224
Mailing address
444 CLINCHFIELD ST, SUITE 201B, KINGSPORT, TN 37660-3858
(423) 302-3135
(423) 230-0224
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316328024
—
VA
05
—
Q013946
—
TN
Enumeration date
06/18/2015
Last updated
03/29/2019
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