Individual
DR. DONALD AUGUST BALUN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE, SUITE 330, SPRINGFIELD, MO 65804-2201
(417) 820-8180
(417) 820-8183
Mailing address
126 MISSOURI AVE, MCXP-CCS-CR, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417
(573) 596-0524
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2008026256
MO
2084P0804X
Child & Adolescent Psychiatry Physician
215032-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255387577
—
MO
05
—
174243001
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00635669
RR MEDICARE
MO
Enumeration date
05/26/2006
Last updated
04/08/2010
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