Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
Ballad Health Medical Associates, BHMA Sleep Medicine Bristol, MSMG Sleep Diagnostics Bristol
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
3175 LINDEN DR, STE 3, BRISTOL, VA 24202-5849
(276) 258-4734
(276) 258-4736
Mailing address
3175 LINDEN DR, STE 3, BRISTOL, VA 24202-5849
(276) 258-4734
(276) 258-4736
Taxonomy
Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730542473
—
VA
01
—
622863200
DEPARTMENT OF LABOR
VA
Enumeration date
03/31/2016
Last updated
03/29/2019
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