person
Sally J Ballard, PA-C
Medical Physician Assistant in Goreville, Illinois
NPI 1720288756

Sally J Ballard is a Medical Physician Assistant based in Goreville, IL and is specialized in Medical. Sally J Ballard practices in Goreville, IL and has the professional credentials of PA-C. The NPI Number for Sally J Ballard is 1720288756 and holds a License No. (Illinois).

The current practice location address for Sally J Ballard is 200 S Broadway, Goreville, IL and can be reached out via phone at 618-995-2396 and via fax at 618-995-2947.

Location: 200 S Broadway, Goreville, IL, 62939
person
Provider Profile Details
NPI Number
1720288756
Provider Name
Sally J Ballard
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
200 S Broadway, Goreville, IL, 62939
Phone Number
618-995-2396
Fax Number
618-995-2947
Provider Enumeration Date
07/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
215389 01 IL MEDICARE GROUP NUMBER
institution
Provider Business Practice Location Address Details
Address
200 S Broadway
City
State
Zip
62939
Phone Number
618-995-2396
Fax Number
618-995-2947
person
Provider Business Mailing Address Details
Address
200 S Broadway
City
State
Zip
62939
Phone Number
618-995-2396
Fax Number
618-995-2947
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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