MEDICARE: DR. MELANIE JOAN BALLARD O.D.

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
1	152W00000X	Optometrist	5781	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700018520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE JOAN BALLARD O.D.

Provider Business Mailing Address
First Line	:	7510 PLUMB RD
Second Line	:
City	:	GALENA
State	:	OH
Zip	:	43021-9735
Country	:	US
Telephone Number	:	614-266-4381
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 POLARIS PKWY
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-2037
Country	:	US
Telephone Number	:	614-768-7861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	01/23/2025

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