Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG IM KPT, Ballad Health Medical Associates, BHMA Internal Medicine Kingsport
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
1916 BROOKSIDE DR, KINGSPORT, TN 37660-4602
(423) 392-6000
(423) 392-6030
Mailing address
1916 BROOKSIDE DR, KINGSPORT, TN 37660-4602
(423) 392-6000
(423) 392-6030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346270972
—
VA
05
—
3709280
—
TN
Enumeration date
07/03/2006
Last updated
05/02/2025
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