Ballard, Robert Blakeslee
Ballard, Robert Blakeslee is an individual health care provider with primary practice located at 2000 E Milestone Dr , Appleton WI 54913-6701. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Ballard, Robert Blakeslee can be contacted via phone (920) 731-8289.Contact Information
Primary practice address
2000 E Milestone Dr
Appleton WI 54913-6701
Phone: (920) 731-8289
Fax: (920) 832-0444
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 41244 020 | Wisconsin |
Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 42169 | Georgia |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 12605 | Louisiana |
Profile Details
NPI number | 1902898182 |
---|---|
LBN Legal business name | Ballard, Robert Blakeslee |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 16th, 2005 |
Last updated | Jul 19th, 2023 - about 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1902898182 | NPPES |
Wisconsin | MEDICAID | 30094300 |
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