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Individual
BLAKE DARBY BALLARD
Active
Individual
BLAKE DARBY BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11576
GA
363AS0400X
Surgical Physician Assistant
11576
GA
Other
Enumeration date
09/23/2021
Last updated
09/04/2026
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