Eddie R Ballard, CSW

Individual provider Active NPI Case Manager/Care Coordinator · Kennett, MO

NPI 1447586474 · NPPES record last updated Oct 27, 2009

Key facts

NPI
1447586474
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
925 State Hwy VV
Kennett, MO 63857
Phone
(573) 888-5925
Fax
(573) 888-9365
NPI assigned
Oct 27, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

925 State Hwy VV
Kennett, MO 63857

Mailing address

925 State Hwy VV
PO Box 71
Kennett, MO 63857
Phone (573) 888-5925

Other providers in Kennett, MO

All providers in Kennett, MO · Case Manager/Care Coordinator in Missouri

Sources for this page

Verify at the official NPI Registry.