Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG OB GYN A, Ballad Health Medical Associates, BHMA OB/GYN and Womens Health Kingsport
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
2002 BROOKSIDE DR, STE 300, KINGSPORT, TN 37660-4634
(423) 392-6370
(423) 392-6081
Mailing address
2002 BROOKSIDE DR, STE 300, KINGSPORT, TN 37660-4634
(423) 392-6370
(423) 392-6081
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548270879
—
VA
05
—
3709288
—
TN
Enumeration date
08/09/2006
Last updated
03/29/2019
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