Individual
RANCE BALLARD WILBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 WEST ST STE 100, GERMANTOWN, TN 38138
(901) 440-8482
(901) 440-8582
Mailing address
2215 WEST ST STE 100, GERMANTOWN, TN 38138-3874
(901) 440-8482
(901) 440-8582
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
20766
MS
2084N0400X
Neurology Physician
51679
SC
2084N0400X
Neurology Physician
Primary
56737
TN
2084N0400X
Neurology Physician
IP958
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04520877
—
MS
05
—
230387001
—
AR
05
—
Q063676690
—
TN
Enumeration date
07/14/2008
Last updated
12/16/2024
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