Blue Ridge Medical Management Corporation

NPI #1316357593 in Johnson City, Tennessee

Provider Information

NPI Number: 1316357593
Entity Type: Organization
Organization Name: Blue Ridge Medical Management Corporation
Primary Specialty: Internal Medicine
Enumeration Date: Apr 28, 2014
Last Updated: Jul 8, 2015

Practice Location

Address: 408 N STATE OF FRANKLIN RD
Address 2: SUITE 24 A
City: Johnson City
State: Tennessee
ZIP Code: 37604-6089
Phone: (423) 431-1810

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Internal Medicine	207R00000X	Primary

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