Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL KILGORE (VP)
(423) 302-3051
Entity
Organization
Contact information
Practice address
2030 TEMPLE HILL RD, ERWIN, TN 37650-8721
(423) 735-4700
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
(423) 282-1657
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
02/02/2022
Last updated
04/22/2025
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