Provider Demographics
NPI:1942205638
Name:WRIGHT, BALLARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:BALLARD
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:280 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2925
Mailing Address - Country:US
Mailing Address - Phone:859-278-1316
Mailing Address - Fax:859-276-1574
Practice Address - Street 1:2416 REGENCY RD
Practice Address - Street 2:STE 30
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2954
Practice Address - Country:US
Practice Address - Phone:859-278-1316
Practice Address - Fax:859-276-1574
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13962208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000049168OtherANTHEM BC/BS
KY053587006OtherRAILROAD MCR
KY50002212OtherPASSPORT
KY64139629Medicaid
KY163663600OtherDEPARTMENT OF LABOR
KY935670OtherUMWA
KY935670OtherUMWA
KY64139629Medicaid