Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG Gen Surg ELIZ, Ballad Health Medical Associates, BHMA General Surgery Elizabethton
Organization subpart
No
Provider details
NPI number
Authorized official
CARL S KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
1497 WEST ELK AVE, STE 10, ELIZABETHTON, TN 37643
(423) 542-7440
(423) 542-7445
Mailing address
1497 WEST ELK AVE, STE 10, ELIZABETHTON, TN 37643
(423) 542-7440
(423) 542-7445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1521769
—
TN
05
—
5911815
—
NC
01
—
622164600
DEPARTMENT OF LABOR
TN
Enumeration date
12/08/2010
Last updated
05/02/2025
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