Provider Demographics
NPI:1649489014
Name:BALLARD, ARTHUR R II (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:R
Last Name:BALLARD
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:R
Other - Last Name:BALLARD
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:23081 HARBORVIEW RD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-2153
Mailing Address - Country:US
Mailing Address - Phone:941-235-8762
Mailing Address - Fax:941-237-5691
Practice Address - Street 1:23081 HARBORVIEW RD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-2153
Practice Address - Country:US
Practice Address - Phone:941-235-8762
Practice Address - Fax:941-237-5691
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188710207R00000X
MDD766952085R0202X
OH35-0979022085R0202X
FLME1123242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine