Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPOARTION
Active
Other names
BHMA Pediatric Orthopedics Johnson City, Ballad Health Medical Associates, MSMG Pediatric Orthopedics Johnson City
Organization subpart
No
Provider details
NPI number
Authorized official
CARL KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
410 N STATE OF FRANKLIN RD STE 130, JOHNSON CITY, TN 37604-6972
(423) 431-2477
(423) 431-2478
Mailing address
410 N STATE OF FRANKLIN RD STE 130, JOHNSON CITY, TN 37604-6972
(423) 431-2477
(423) 431-2478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
2080S0010X
Pediatric Sports Medicine Physician
—
—
Other
Enumeration date
01/22/2018
Last updated
05/02/2025
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