Individual
MATTHEW T. BALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2146
(901) 683-0055
(901) 685-2969
Mailing address
100 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2146
(901) 683-0055
(901) 685-2969
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
35071913B
OH
2085R0001X
Radiation Oncology Physician
50791
TN
2085R0001X
Radiation Oncology Physician
L0014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45529701
—
TX
Enumeration date
09/22/2006
Last updated
12/11/2024
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