Organization
LAURIE K. BALLEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE K. BALLEW D.O. (OWNER)
(270) 558-4174
Entity
Organization
Contact information
Practice address
657 LONE OAK RD STE 2, PADUCAH, KY 42003-4547
(270) 558-4174
(270) 534-5753
Mailing address
657 LONE OAK RD STE 2, PADUCAH, KY 42003-4547
(270) 558-4174
(270) 534-5753
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2436
MEDICAL LICENSE
KY
Enumeration date
09/11/2018
Last updated
03/27/2019
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