DR. MARK G BALLIF (NPI# 1376522573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376522573 |
Entity Type | Individual |
Full Name | DR. MARK G BALLIF |
Credential | M.D., |
Practice Address |
4360 Washington Blvd Ogden UT 84403-1866 |
Mailing Address |
4360 Washington Blvd Ogden UT 84403-6529 |
Practice Telephone | 8014760494 |
Mailing Telephone | 8014760494 |
Mailing Fax Number | 8014760067 |
Enumeration Date | 2006-01-16 |
Last Update Date | 2017-12-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207W00000X | Ophthalmology | 176195-1205 | UT | Allopathic & Osteopathic Physicians |
Street Address |
4360 WASHINGTON BLVD |
City | OGDEN |
State | UT |
Zip Code | 84403-1866 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629064027 | Robert Willliam Wing | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2005-09-21 |
1992123376 | Brock C Hansen | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2014-04-02 |
1750643896 | Devin B Farr | Optometrist | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2012-06-14 |
1326351727 | Michael Lonnie Bullard | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2010-07-14 |
1629282439 | Ogden Refractive, L.L.C. | Clinic/Center | 4360 Washington Blvd, Ste. A, Ogden, UT 84403-1866 | 2007-05-10 |
1700927043 | Mt Ogden Eye Center LLC | Optometrist | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2007-02-09 |
1376656124 | Jed T Poll | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2006-08-16 |
1841200284 | Claron Douglas Alldredge | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2006-08-08 |
1053391771 | Michael B Wilcox | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403 | 2006-01-19 |
1932188133 | John D Armstrong | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2006-01-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
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Taxonomy Code | 207W00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912989518 | David E Brodstein | Ophthalmology | 874 Country Hills Dr, Ogden, UT 84403-2208 | 2005-11-18 |
1457333064 | Bradley W Richards | Ophthalmology | 875 Country Hills Dr, Ogden, UT 84403-2200 | 2005-11-18 |
1629064027 | Robert Willliam Wing | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2005-09-21 |
1992123376 | Brock C Hansen | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2014-04-02 |
1437416500 | Brice J. Williams, M.d., P.C. | Ophthalmology | 4403 Harrison Blvd., Ste-3600, Ogden, UT 84403-3285 | 2012-04-13 |
1326351727 | Michael Lonnie Bullard | Ophthalmology | 4360 Washington Blvd, Ogden, UT 84403-1866 | 2010-07-14 |
1831329309 | Jackson Lever | Ophthalmology | 875 Country Hills Dr, Ogden, UT 84403-2200 | 2009-07-20 |
1154574390 | Brice Jason Williams | Ophthalmology | 4403 Harrison Blvd., Suite 3600, Ogden, UT 84403-3285 | 2008-10-31 |
1073797809 | Benjamin T Dastrup | Ophthalmology | 875 Country Hills Dr, Ogden, UT 84403-2200 | 2007-12-28 |
1912001165 | Fred E Clayson Md PC | Ophthalmology | 4403 Harrison Blvd, #3600, Ogden, UT 84403-3285 | 2006-09-09 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.