| Blue Ridge Medical Management Corporation | |
|
200 Med Tech Pkwy Suite 108 Johnson City TN 37604-2278 | |
| (423) 915-5033 | |
| (423) 915-5179 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Med Tech Pkwy, Johnson City, Tennessee |
| Authorized Official Name and Position | Carl Steven Kilgore (PRESIDENT BRMMC) |
| Authorized Official Contact | 4233023051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Medical Management Corporation 200 Med Tech Pkwy Suite 108 Johnson City TN 37604-2278 Ph: (423) 915-5033 | Blue Ridge Medical Management Corporation 200 Med Tech Pkwy Suite 108 Johnson City TN 37604-2278 Ph: (423) 915-5033 |
| NPI Number | 1942520267 |
|---|---|
| Provider Enumeration Date | 06/09/2010 |
| Last Update Date | 05/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942520267 | NPI | - | NPPES |
| Q017164 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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