Organization
DR. CHARLES J. BALLAY II M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOSPEH BALLAY II M.D. (PRESIDENT)
(504) 934-8550
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD,, 707 N, MARRERO, LA 70072
(479) 806-3626
(504) 934-8549
Mailing address
1111 MEDICAL CENTER BLVD, STE 707N, MARRERO, LA 70072-3151
(504) 934-8550
(504) 934-8549
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD205801
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2351753
—
LA
Enumeration date
09/23/2014
Last updated
09/23/2014
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