Keith E. Ballinger PA C

NPI 1114934759 - Physician Assistant - 363A00000X

NPI Details
NPI 1114934759
Gender Male
Enumeration Date 08/02/2006
Last Updated 06/01/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
168 COURTHOUSE SQUARE
TOLEDO IL, 62468, US
Phone (217) 849-3151
Fax (217) 849-3123
Business Location
1005 HEALTH CENTER DR # I
SYSTEM PRACTICES, SUITE 202
MATTOON IL, 61938-4693, US
Phone (217) 258-2576
Fax (217) 258-4175
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085001872
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According to our database, Mr. Keith E. Ballinger PA C NPI is 1114934759, taxonomy code is 363A00000X and license number is 085001872, license state is located at Illinois. Keith E. Ballinger PA C physically located at 168 Courthouse Square, Toledo IL, 62468. NPI Number Keith E. Ballinger PA C has the Individual type.

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1114934759 NPI number is provided on an as is basis without warranty of any kind. 1114934759 is maintained by the National Plan & Provider Enumeration System. The contents of Keith E. Ballinger PA C are for informational purposes only.