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Organization

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Active
Other names
Ballad Health Medical Associates, BHMA Pediatrics Kingsport, MSMG PEDS KPT
Organization subpart
No

Provider details

NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 302-3051
Entity
Organization

Contact information

Practice address
2002 BROOKSIDE DR, SUITE 200, KINGSPORT, TN 37660-4634
(423) 224-3933
(423) 224-3934
Mailing address
2002 BROOKSIDE DR, SUITE 200, KINGSPORT, TN 37660-4634
(423) 224-3933
(423) 224-3934

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992105431
VA
05
Q008812
TN
Enumeration date
09/03/2014
Last updated
05/02/2025
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