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General NPI Number Information
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NPI Number | 1174571749
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Entity Type | Individual
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Provider Name | PHILLIP SCOTT BALLINGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 525 WESTERN AVE STE 302A
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City | CONWAY
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State | AR
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Zip | 72034-4981
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Country | US
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Telephone | 501-205-8095
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Fax | 501-205-8533
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Provider Business Mailing Address
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Address Line | PO BOX 9662
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City | CONWAY
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State | AR
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Zip | 72033-9662
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Country | US
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Telephone | 501-852-1363
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Fax | 501-852-1364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 34925
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD.34694
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | E2157
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License Number State | AR
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