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Individual

DR. SCOTT MICHAEL BALLMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 E PRIMROSE ST, SPRINGFIELD, MO 65807-5154
(417) 269-7900
(417) 269-7990
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3462

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2016010980
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467710558
MO
05
200028723
MO
Enumeration date
04/26/2012
Last updated
12/27/2018
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