Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Transitional Care Kingsport, MSMG Transitional Care, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
2000 BROOKSIDE DR, 1ST FLOOR ROOM 12, KINGSPORT, TN 37660-4627
(423) 857-5907
(423) 857-5904
Mailing address
2000 BROOKSIDE DR, 1ST FLOOR ROOM 12, KINGSPORT, TN 37660-4627
(423) 857-5907
(423) 857-5904
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669918314
—
VA
05
—
Q026077
—
TN
Enumeration date
01/18/2017
Last updated
03/29/2019
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