MEDICARE: DR. BALLARD D WRIGHT M.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	208VP0014X	Interventional Pain Medicine Physician	13962	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000049168	OTHER	KY	ANTHEM BC/BS
2	053587006	OTHER	KY	RAILROAD MCR
3	50002212	OTHER	KY	PASSPORT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	163663600	OTHER	KY	DEPARTMENT OF LABOR
6	935670	OTHER	KY	UMWA

General Provider Information

NPI Number	:	1942205638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BALLARD D WRIGHT M.D.

Provider Business Mailing Address
First Line	:	280 PASADENA DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2925
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-276-1574

Provider Business Practice Location Address
First Line	:	2416 REGENCY RD
Second Line	:	STE 30
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2954
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-276-1574

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/15/2013

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