Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
Ballad Health Medical Associates, BHMA Heart and Vascular Care Mountain City, MSMG Cardiology MTN
Organization subpart
No
Provider details
NPI number
Authorized official
CARL S KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization
Contact information
Practice address
1901 S SHADY ST STE 1, MOUNTAIN CITY, TN 37683-2021
(423) 727-6674
(423) 727-1268
Mailing address
1901 S SHADY ST STE 1, MOUNTAIN CITY, TN 37683-2021
(423) 727-6674
(423) 727-1268
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982013215
—
VA
05
—
Q009486
—
TN
Enumeration date
08/12/2014
Last updated
03/29/2019
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