Healthcare Provider Details

I. General information

NPI: 1487040838
Provider Name (Legal Business Name): BALLARD PAIN & WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7063 VETERANS PKWY
PELL CITY AL
35125-5114
US

IV. Provider business mailing address

7067 VETERANS PKWY STE 210
PELL CITY AL
35125-5128
US

V. Phone/Fax

Practice location:
  • Phone: 205-338-3301
  • Fax:
Mailing address:
  • Phone: 205-405-7348
  • Fax: 205-338-0550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GAYLYN M HORNE
Title or Position: OWNER
Credential: MD
Phone: 205-908-3310