Individual
DR. PHILLIP W BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2610 TENDERFOOT HILL ST, COLORADO SPRINGS, CO 80906
(719) 576-3901
(719) 576-2025
Mailing address
2 S CASCADE AVE, SUITE 140, COLORADO SPRINGS, CO 80903-1624
(719) 538-2950
(719) 538-2996
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0023871
CO
2084N0400X
Neurology Physician
DR.0023871
CO
2084P0800X
Psychiatry Physician
DR.0023871
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01238716
—
CO
Enumeration date
10/17/2005
Last updated
06/15/2018
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