Individual
MR. PAUL ALLEN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
5025 SHED RD, BOSSIER CITY, LA 71111-5434
(318) 798-4623
(318) 795-4742
Mailing address
1455 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-6000
(318) 798-4500
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
307181
LA
363AS0400X
Surgical Physician Assistant
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14219851
CAQH
—
05
—
2457578
—
LA
Enumeration date
09/05/2017
Last updated
02/02/2026
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