| Blue Ridge Medical Management Corp | |
| 
					1905 American Way Kingsport TN 37660-5882  | |
| (423) 578-8451 | |
| (423) 230-8224 | 
| Full Name | Blue Ridge Medical Management Corp | 
|---|---|
| Speciality | Family Medicine | 
| Location | 1905 American Way, Kingsport, Tennessee | 
| Authorized Official Name and Position | Carl Kilgore (EXECUTIVE) | 
| Authorized Official Contact | 4233023051 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Blue Ridge Medical Management Corp 1021 W Oakland Ave Ste 310 Johnson City TN 37604-2192 Ph: (423) 952-2111  | Blue Ridge Medical Management Corp 1905 American Way Kingsport TN 37660-5882 Ph: (423) 578-8451  | 
| NPI Number | 1528723251 | 
|---|---|
| Provider Enumeration Date | 11/08/2021 | 
| Last Update Date | 10/01/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1528723251 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
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