Ballantine, Percy

Ballantine, Percy is an individual health care provider with primary practice located at Anna Marsh Lane , Brattleboro VT 05302-0803. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Ballantine, Percy can be contacted via phone (802) 257-7785.

Contact Information

Primary practice address
Anna Marsh Lane Brattleboro VT 05302-0803
Phone: (802) 257-7785
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 042-0005715 Vermont
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 042-0005715 Vermont

Profile Details

NPI number 1871580779
LBN Legal business name Ballantine, Percy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Mar 17th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871580779 NPPES
Vermont MEDICAID VT 0006779

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