Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
Regional Cancer Center at Indian Path Medical Center, Ballad Health Medical Associates, BHMA Hematology and Oncology Kingsport
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN CARL KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
2205 PAVILION DR, SUITE 101, KINGSPORT, TN 37660-4641
(423) 857-6466
(423) 857-6456
Mailing address
2205 PAVILION DR STE 101, KINGSPORT, TN 37660-4641
(423) 857-6466
(423) 857-6456
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516429
—
TN
05
—
1598995789
—
VA
Enumeration date
07/22/2009
Last updated
03/29/2019
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