Ballard, Timothy D

Ballard, Timothy D is an sole proprietor health care provider with primary practice located at 4881 Sugar Maple Dr Bldg 830, Wright Patterson Afb OH 45433-5529. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Ballard, Timothy D can be contacted via phone (937) 257-1942.

Contact Information

Primary practice address
4881 Sugar Maple Dr Bldg 830 Wright Patterson Afb OH 45433-5529
Phone: (937) 257-1942
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.088367 Ohio
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 35-88367 Ohio

Profile Details

NPI number 1821075730
LBN Legal business name Ballard, Timothy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 30th, 2005
Last updated May 22nd, 2014 - about 10 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 1821075730 NPPES
Ohio MEDICAID 2764398
Ohio Other 000000510374
Ohio Other 000000551694

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