Ballard, Gary

Ballard, Gary is an individual health care provider with primary practice located at 2740 W Lake Mendocino Dr , Ukiah CA 95482-3044. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ballard, Gary can be contacted via phone (707) 462-9028.

Contact Information

Primary practice address
2740 W Lake Mendocino Dr Ukiah CA 95482-3044
Phone: (707) 462-9028
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G26847 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X DR-14824 Colorado

Profile Details

NPI number 1902826860
LBN Legal business name Ballard, Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jun 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902826860 NPPES
Colorado MEDICAID 53838068

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