Individual
SAMUEL QUINN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(920) 320-2436
Mailing address
800 LAKEFRONT WAY, TWO RIVERS, WI 54241-3301
(906) 241-7131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81102-21
WI
Other
Enumeration date
04/01/2020
Last updated
09/13/2023
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