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General NPI Number Information
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NPI Number | 1437386737
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Entity Type | Individual
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Provider Name | BRAD R BALLARD MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 5821 S SPRAGUE CT
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City | TACOMA
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State | WA
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Zip | 98409-6903
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Country | US
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Telephone | 800-664-9225
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Fax | 253-396-4260
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Provider Business Mailing Address
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Address Line | 5821 S SPRAGUE CT
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City | TACOMA
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State | WA
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Zip | 98409-6903
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Country | US
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Telephone | 800-664-9225
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Fax | 253-396-4260
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD61561497
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 56524
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License Number State | CO
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