Provider Demographics
NPI:1528355625
Name:BALLARD, KHRISTOPHER D (OD)
Entity type:Individual
Prefix:DR
First Name:KHRISTOPHER
Middle Name:D
Last Name:BALLARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 W MAIN ST
Mailing Address - Street 2:P.O. BOX 670
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-7439
Mailing Address - Country:US
Mailing Address - Phone:937-393-3212
Mailing Address - Fax:
Practice Address - Street 1:934 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7439
Practice Address - Country:US
Practice Address - Phone:937-393-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-09
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6013/T2928152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist