Ballenger, Fred Jackson
Ballenger, Fred Jackson is an individual health care provider with primary practice located at 2602 Franklin Rd Sw , Roanoke VA 24014-1010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Ballenger, Fred Jackson can be contacted via phone (540) 344-1400.Contact Information
Primary practice address
2602 Franklin Rd Sw
Roanoke VA 24014-1010
Phone: (540) 344-1400
Fax: (540) 344-7133
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 0101027649 | Virginia |
Profile Details
| NPI number | 1447258728 |
|---|---|
| LBN Legal business name | Ballenger, Fred Jackson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Mar 29th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447258728 | NPPES |
| Virginia | MEDICAID | 6091270 | |
| Virginia | Other | CG1162 |
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