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Individual

WENDY MICHELLE BALLENGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
7148 KERR STREET PLACE, SUITE 110, OLIVE BRANCH, MS 38654-3865
(662) 222-6724
(901) 350-5024
Mailing address
7148 KERR STREET PLACE, SUITE 110, OLIVE BRANCH, MS 38654
(662) 222-6724
(901) 350-5024

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MS25393
MS
207R00000X
Internal Medicine Physician
R2208
KY
208000000X
Pediatrics Physician
MS29353
MS
208000000X
Pediatrics Physician
Primary
R2208
KY

Other

Enumeration date
05/12/2009
Last updated
02/10/2023
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