Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 22421 | KY |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 22421 | KY |
NPI | 1134230709 |
---|---|
Provider Name | Peter F. Ballard |
First Address | Danville, KY 40422-9037 |
Second Address | Danville, KY 40422-9037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000041698 | ANTHEM PIN (01) | KY |
64224215 | (05) | KY |
B09640 | (02) | KY |