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Thomas Kelly Ballard IV
Student in an Organized Health Care Education/Training Program in Southaven, Mississippi
NPI 1245975226

Thomas Kelly Ballard IV is a Student in an Organized Health Care Education/Training Program based in Jackson, MS. Thomas Kelly Ballard IV practices in Southaven, MS. The NPI Number for Thomas Kelly Ballard IV is 1245975226 and holds a License No. (Mississippi).

The current practice location address for Thomas Kelly Ballard IV is 7601 Southcrest Pkwy, Southaven, MS and can be reached out via phone at 662-772-4696.

Location: 7601 Southcrest Pkwy, Southaven, MS, 38301-1609
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245975226
Provider Name
Thomas Kelly Ballard IV
Credential
Provider Entity Type
Individual
Gender
Male
Address
7601 Southcrest Pkwy, Southaven, MS, 38301-1609
Phone Number
662-772-4696
Fax Number
Provider Enumeration Date
05/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7601 Southcrest Pkwy
City
Southaven
State
Mississippi
Zip
38671-4739
Phone Number
662-772-4696
Fax Number
person
Provider Business Mailing Address Details
Address
7601 Southcrest Pkwy
City
Southaven
State
Mississippi
Zip
38671-4739
Phone Number
662-772-4696
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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