Provider Demographics
NPI:1033488895
Name:BALLARD, RYAN MCKINLEY (PA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MCKINLEY
Last Name:BALLARD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:101 NE 82ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-4401
Mailing Address - Country:US
Mailing Address - Phone:405-563-6223
Mailing Address - Fax:405-212-3604
Practice Address - Street 1:101 NE 82ND ST STE 101
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-4401
Practice Address - Country:US
Practice Address - Phone:405-563-6223
Practice Address - Fax:405-212-3604
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2025-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2095363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant