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Individual

DR. EVAN A BALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2950 CURVE CREST BLVD W, STILLWATER, MN 55082-5085
(651) 275-3000
(651) 275-3027
Mailing address
1719 TOWER DR W, STE 100, STILLWATER, MN 55082-7512
(651) 275-3000
(651) 275-3027

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
26825
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001022700
MN
01
180014296
RAILROAD MEDICARE
MN
Enumeration date
06/15/2005
Last updated
03/06/2014
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