Individual
GARY H BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
403 MCBRIEN RD, EAST RIDGE, TN 37412-3223
(423) 894-3589
(423) 892-3378
Mailing address
992 CLIFT CAVE RD, SODDY DAISY, TN 37379-5700
(423) 332-9218
(423) 605-4704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN0000063398
TN
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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