Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Blue Ridge Medical Management

Organization Vascular Surgery Physician · NPI 1114340445

Blue Ridge Medical Management provides Vascular Surgery Physician services in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2014.

Licensed in
TN
In the registry since
2014

Practice location Address checks out

310 N State Of Franklin Rd Ste 101B
Johnson City, TN 37604-6008
Phone: (423) 929-7393
Fax: (423) 929-0872
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 48573 (TN)

Record details

NPI number1114340445
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carl Kilgore — President/Ceo · (423) 915-5185
Other names Msmg Vascular Surgery Jc
NPI enumeratedJanuary 22, 2014
Last updated in NPPESFebruary 27, 2017
Mailing address310 N State Of Franklin Rd, Suite 101b, Johnson City, TN 37604-6008

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