Individual
MRS. AMY M. BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
830 S GLOSTER ST, NMMC EAST TOWER THIRD FLOOR, TUPELO, MS 38801-4934
(662) 377-7170
(662) 377-7180
Mailing address
PO BOX 7062, TUPELO, MS 38802-7062
(662) 377-7170
(662) 377-7180
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA027
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126597
—
MS
Enumeration date
10/04/2006
Last updated
07/08/2007
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