Provider Demographics
NPI:1114113529
Name:P. SCOTT BALLINGER, M.D., PA
Entity Type:Organization
Organization Name:P. SCOTT BALLINGER, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-305-2251
Mailing Address - Street 1:1907 E BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6973
Mailing Address - Country:US
Mailing Address - Phone:501-305-2251
Mailing Address - Fax:501-305-2325
Practice Address - Street 1:1907 E BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6973
Practice Address - Country:US
Practice Address - Phone:501-305-2251
Practice Address - Fax:501-305-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-2157207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARG07803Medicare UPIN