Individual
JOHN A BALLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2605 KENTUCKY AVE STE 601, PADUCAH, KY 42003-3806
(270) 408-4368
(270) 408-3272
Mailing address
2605 KENTUCKY AVE STE 601, PADUCAH, KY 42003-3806
(270) 408-4368
(270) 408-3272
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
ME104223
FL
207Y00000X
Otolaryngology Physician
TP352
KY
207YS0123X
Facial Plastic Surgery Physician
Primary
43767
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100138780
—
KY
Enumeration date
05/11/2007
Last updated
09/07/2023
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