Provider Demographics
NPI:1902844269
Name:BALLAS, WILLIAM E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:BALLAS
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:15530 E. BRONCOS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7111
Mailing Address - Country:US
Mailing Address - Phone:720-851-2000
Mailing Address - Fax:720-851-2009
Practice Address - Street 1:15530 E. BRONCOS PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-7111
Practice Address - Country:US
Practice Address - Phone:720-851-2000
Practice Address - Fax:720-851-2009
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1715363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44870043Medicaid
CO44870043Medicaid
COP88021Medicare UPIN
CO44870043Medicaid