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Individual

ARDEN N BALLARD II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2735 HIGHWAY 190 STE D, MANDEVILLE, LA 70471-3433
(985) 778-2510
Mailing address
100 COVINGTON ST UNIT 1166, MADISONVILLE, LA 70447-5048
(985) 231-2151

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200427.RX
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05775557
MS
05
2386824
LA
Enumeration date
08/30/2010
Last updated
05/29/2020
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