Sally J Ballard, PA-C is a
Physician Assistant - Medical based in Goreville, Illinois. Sally J Ballard is licensed to practice in Illinois (license number ) and her current practice location is
200 S Broadway, Goreville, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 995-2396.
NPI number for Sally J Ballard is 1720288756 and her current mailing address is 200 S Broadway, Po Box 40, Goreville, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1720288756.
Provider's Profile
Full Name | Sally J Ballard |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 200 S Broadway, Goreville, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1720288756
- Provider Enumeration Date: 07/18/2007
- Last Update Date: 11/12/2007
Medical Identifiers
Medical identifiers for Sally J Ballard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720288756 | NPI | - | NPPES |
215389 | Other | IL | MEDICARE GROUP NUMBER |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sally J Ballard is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Sally J Ballard, PA-C 200 S Broadway, Po Box 40, Goreville, IL 62939 Ph: (618) 995-2396 | Sally J Ballard, PA-C 200 S Broadway, Goreville, IL 62939 Ph: (618) 995-2396 |
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