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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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 1902898182 NPPES
Wisconsin MEDICAID 30094300

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