National Provider Identifier Database

JORDAN B BALLANTYNE, OD – NPI #1326352212
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

JORDAN B BALLANTYNE, OD
302 W 3RD ST
LA JUNTA, CO81050-1430
Phone: 719-383-0134
Fax: 719-404-1825
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for JORDAN B BALLANTYNE

NPI Number 1326352212
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/03/2010
Last updated 10/10/2016 - About 10 years ago
Sole proprietor1 No
Identifiers
  • CO License #: 2799
  • CO Medicaid: 93920288
  • CO Other: 12141883 CAQH
  • CO Other: COA105677 MEDICARE INDIVIDUAL PTAN
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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