Provider Demographics
NPI:1205321494
Name:B&B NEONATOLOGY
Entity type:Organization
Organization Name:B&B NEONATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BALAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-430-3176
Mailing Address - Street 1:3213 W MAIN ST STE 128
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2314
Mailing Address - Country:US
Mailing Address - Phone:605-430-3176
Mailing Address - Fax:866-673-1339
Practice Address - Street 1:3213 W MAIN ST STE 128
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2314
Practice Address - Country:US
Practice Address - Phone:605-430-3176
Practice Address - Fax:866-673-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty