Provider Demographics
NPI:1326404328
Name:BALLARD, DAVID LINCOLN III (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LINCOLN
Last Name:BALLARD
Suffix:III
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 GILES RD
Mailing Address - Street 2:
Mailing Address - City:EAST KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03827-2009
Mailing Address - Country:US
Mailing Address - Phone:603-583-0793
Mailing Address - Fax:
Practice Address - Street 1:800 ISLINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4272
Practice Address - Country:US
Practice Address - Phone:603-436-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH183500000X183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist