Provider Demographics
NPI:1801835624
Name:BALLANTINE, WILLIAM CLAYTON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLAYTON
Last Name:BALLANTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PEACHTREE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3395
Mailing Address - Country:US
Mailing Address - Phone:828-277-6789
Mailing Address - Fax:828-277-6780
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3395
Practice Address - Country:US
Practice Address - Phone:828-277-6789
Practice Address - Fax:828-277-6780
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine