Organization
BLUE RIDGE MEDICAL MANAGEMENT
Active
Other names
Ballad Health Medical Associates, BHMA General Surgery Lebanon
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
58 CARROLL STREET, SUITE 2D, LEBANON, VA 24266
(276) 883-8091
(276) 883-8090
Mailing address
58 CARROLL STREET, SUITE 2D, LEBANON, VA 24266
(276) 883-8091
(276) 883-8090
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020487828
DEPARTMENT OF LABOR
VA
05
—
1790167351
—
VA
Enumeration date
06/19/2015
Last updated
05/02/2025
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