Healthcare Provider Details
I. General information
NPI: 1811008394
Provider Name (Legal Business Name): PETER F. BALLARD, M.D., PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
218 SOUTHTOWN DR
DANVILLE KY
40422-2534
US
IV. Provider business mailing address
PO BOX 1429
FRANKFORT KY
40602-1429
US
V. Phone/Fax
- Phone: 859-936-9430
- Fax: 859-936-0458
- Phone: 502-226-3858
- Fax: 502-223-9829
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
FRANCIS
BALLARD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 859-936-9430