Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
MSMG Neuro ABG, BHMA Neurology Abingdon, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CARL S KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 312, ABINGDON, VA 24211-7659
(276) 258-3733
(276) 258-3734
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 312, ABINGDON, VA 24211-7659
(276) 258-3733
(276) 258-3734
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020487832
DEPARTMENT OF LABOR/BLACK LUNG
VA
01
—
020487844
DEPARTMENT OF LABOR/ENERGY & FECA
VA
05
—
1669793493
—
VA
05
—
7100161550
—
KY
01
—
DF7910
RAILROAD MEDICARE
VA
Enumeration date
06/16/2010
Last updated
03/29/2019
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