Organization
BALLARD WRIGHT, MD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY TERRELL (CFO)
(859) 278-1316
Entity
Organization
Contact information
Practice address
2416 REGENCY ROAD, LEXINGTON, KY 40503
(859) 278-1316
(859) 276-3847
Mailing address
280 PASADENA DR, LEXINGTON, KY 40503-2925
(859) 278-1316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0246146
KY
208VP0014X
Interventional Pain Medicine Physician
Primary
0246146
KY
225100000X
Physical Therapist
0246146
KY
335E00000X
Prosthetic/Orthotic Supplier
6547680001
KY
363AM0700X
Medical Physician Assistant
0246146
KY
363L00000X
Nurse Practitioner
0246146
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6547680001
MEDICARE DMEPOS PTAN
KY
05
—
65926578
—
KY
Enumeration date
07/06/2006
Last updated
07/26/2023
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