Organization · NPI-2

Blue Ridge Medical Management C Orporation

Hospitalist · Greeneville, TN

NPI number1295481869

StatusActive

Last updated in NPPESDec 12, 2022

Details

NPI: 1295481869
Entity type: Organization (NPI-2)
Legal business name: Blue Ridge Medical Management C Orporation
Organization subpart: No
Enumeration date: Feb 23, 2022
Certification date: Dec 12, 2022
Last updated: Dec 12, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208M00000X	Hospitalist	–	–	Yes

Other names

Ballad Health Medical Associates (Doing Business As)

Practice location

1420 Tusculum Blvd
Greeneville, TN 37745-4279

Phone 423-787-5537 · Fax 423-783-5579

Mailing address

509 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2579

Phone 423-302-6565 · Fax 423-952-2175

Authorized official

Carl Kilgore
Vp
4233023051

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