Thomas Kelly Ballard IV
NPI #1245975226 in Southaven, Mississippi
Provider Information
- NPI Number
- 1245975226
- Entity Type
- Individual
- Name
- Thomas Kelly Ballard IV
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- May 3, 2022
- Last Updated
- May 11, 2022
Practice Location
- Address
- 7601 SOUTHCREST PKWY
- City
- Southaven
- State
- Mississippi
- ZIP Code
- 38671-4739
- Phone
- (662) 772-4696
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
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