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1922849520
ETHAN BALLARD
OKLAHOMA CITY, OK
NPI
1922849520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: OK 43505)
Enumeration Date
2024-06-05
Last Update Date
2024-06-05
Business Address
ETHAN BALLARD MD
900 NE 10TH ST
OKLAHOMA CITY, OK 73104-5420
Phone number: 405-271-6110
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Mailing Address
ETHAN BALLARD MD
577 MOODY ST
GOSNELL, AR 72315-6122
Phone number: 870-623-4007
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