Ballard, Brian J

Ballard, Brian J is an individual health care provider with primary practice located at 300 N Broadway Ave , Riverton WY 82501-3545. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ballard, Brian J can be contacted via phone (307) 856-9451.

Contact Information

Primary practice address
300 N Broadway Ave Riverton WY 82501-3545
Fax: (307) 856-8548
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 118T Wyoming

Profile Details

NPI number 1114919826
LBN Legal business name Ballard, Brian J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Oct 7th, 2011 - about 15 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 1114919826 NPPES
Wyoming MEDICAID 104136300
Wyoming Other 0762340001

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