| Bernard H. Ballou Md Pa | |
|
3720 Nw 83rd St Gainesville FL 32606-5603 | |
| (352) 336-3050 | |
| Not Available |
| Full Name | Bernard H. Ballou Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3720 Nw 83rd St, Gainesville, Florida |
| Authorized Official Name and Position | Bernard H. Ballou (PHYSICIAN) |
| Authorized Official Contact | 3523316410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bernard H. Ballou Md Pa Po Box 358720 Gainesville FL 32635-8720 Ph: (352) 331-6410 | Bernard H. Ballou Md Pa 3720 Nw 83rd St Gainesville FL 32606-5603 Ph: (352) 336-3050 |
| NPI Number | 1093963050 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 09/05/2011 |
| Medicare PECOS PAC ID | 4486750288 |
|---|---|
| Medicare Enrollment ID | O20090601000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093963050 | NPI | - | NPPES |
| 002730300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0049070 (Florida) | Primary |
| Provider Name | Bernard Ballou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598773483 PECOS PAC ID: 9335041235 Enrollment ID: I20040122000150 |
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