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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI 1568958775


NPI Information

NPI: 1568958775
Provider Name: BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Doing Business As: BALLAD HEALTH MEDICAL ASSOCIATES

Classification: Urology - 2088P0231X
Entity Type: Organization

Specialization: Pediatric Urology

Address:
408 N STATE OF FRANKLIN RD STE 31F
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-4946
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BLUE RIDGE MEDICAL MANAGEMENT CORPORATION is a pediatric urology urology in Johnson City, TN. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). BLUE RIDGE MEDICAL MANAGEMENT CORPORATION NPI is 1568958775. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ballad Health Medical Associates.

The provider's business location address is:

408 N STATE OF FRANKLIN RD STE 31F
JOHNSON CITY, TN
ZIP 37604-088
Phone: (423) 431-4946
Fax: (423) 431-4947

The provider's authorized official is Carl Kilgore .
The authorized official title is President and has the following contact phone number (423) 302-3051.

The enumeration date for this NPI number is 7/11/2018 and was last updated on 3/29/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12088P0231XUrologyPediatric UrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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