Individual
DR. PERCY RAY BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 267-0900
(617) 267-3667
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 267-0900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
236476
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236476
MASSACHUSETTS BOARD OF REGISTRATION IN MEDICINE LIMITED LICENSE
MA
Enumeration date
06/18/2008
Last updated
09/05/2013
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