Blue Ridge Medical Management Corporation

NPI #1275851974 in Johnson City, Tennessee

Provider Information

NPI Number: 1275851974
Entity Type: Organization
Organization Name: Blue Ridge Medical Management Corporation
Primary Specialty: Internal Medicine
Enumeration Date: May 6, 2010
Last Updated: Jul 8, 2015

Practice Location

Address: 300 MED TECH PKWY
City: Johnson City
State: Tennessee
ZIP Code: 37604-2277
Phone: (423) 431-1810

Authorized Official

Name: MR. CARL STEVEN KILGORE
Title: PRESIDENT
Phone: (423) 915-5100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Nurse Practitioner - Family — Family	363LF0000X
Physician Assistant - Medical — Medical	363AM0700X
Internal Medicine	207R00000X	Primary

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