Individual
DR. CONRAD DIZON BALLECER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W THOMAS RD STE 400, PHOENIX, AZ 85013-4238
(602) 406-3874
(602) 406-2335
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37738
AZ
Other
Enumeration date
06/28/2007
Last updated
12/09/2024
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