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NPI Code Detail

MEDICARE: SARAH A BALLARD PA-C

MEDICARE: SARAH A BALLARD PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50-002821OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150002821OTHEROHSTATE LICNSE
255.000765OTHEROHSTATE PRESCRIBING LICENSE NUMBER

General Provider Information

NPI Number : 1497906234
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH A BALLARD PA-C
Provider Business Mailing Address
First Line : 1235 E ALEX BELL RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-2658
Country : US
Telephone Number : 937-435-6400
Fax Number : 937-435-4793
Provider Business Practice Location Address
First Line : 1235 E ALEX BELL RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-2658
Country : US
Telephone Number : 937-435-6400
Fax Number : 937-435-4793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2008
Last Update Date : 01/05/2014

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Directions to “ SARAH A BALLARD PA-C” Practice Location

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