Provider Demographics
NPI:1023288743
Name:BALLARD, NATASHA ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:ELIZABETH
Last Name:BALLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:ELIZABETH
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1521 GUNBARREL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3124
Mailing Address - Country:US
Mailing Address - Phone:423-531-0911
Mailing Address - Fax:423-531-0912
Practice Address - Street 1:1521 GUNBARREL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3124
Practice Address - Country:US
Practice Address - Phone:423-531-0911
Practice Address - Fax:423-531-0912
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062872207Q00000X
TN46758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine