Individual
BLAKE DARBY BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1462 CLIFTON RD NE STE 280, ATLANTA, GA 30322-1063
(404) 727-7825
Mailing address
675 BURBANK DR SE, SMYRNA, GA 30080-1823
(662) 425-9377
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
11576
GA
Other
Enumeration date
09/23/2021
Last updated
01/28/2025
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