Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
BHMA Pediatric Hospitalists JMH, MSMG Hospital Pediatrics JMH, Ballad Health Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, 4TH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Mailing address
16000 JOHNSTON MEMORIAL DR, 4TH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689056731
—
VA
05
—
Q013972
—
TN
Enumeration date
06/25/2015
Last updated
03/29/2019
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