Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 00003463 | AL |
N | 207U00000X | Nuclear Medicine Specialist | 38202 | TN |
N | 207U00000X | Nuclear Medicine Specialist | ME72144 | FL |
NPI | 1649245218 |
---|---|
Provider Name | James W Ballard |
First Address | Montgomery, AL 36117-3507 |
Second Address | Montgomery, AL 36117-3507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 19/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C76027 | (02) | AL |