MEDICARE: DAVID JOSEPH BALL DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	OS006155L	PA
2	207X00000X	Orthopaedic Surgery Physician	OS006155L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205809407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID JOSEPH BALL DO

Provider Business Mailing Address
First Line	:	2701 COLUMBIA BLVD
Second Line	:	STE A
City	:	BLOOMSBURG
State	:	PA
Zip	:	17815-8804
Country	:	US
Telephone Number	:	570-387-2282
Fax Number	:	570-387-2287

Provider Business Practice Location Address
First Line	:	2701 COLUMBIA BLVD
Second Line	:	STE A
City	:	BLOOMSBURG
State	:	PA
Zip	:	17815-8804
Country	:	US
Telephone Number	:	570-387-2282
Fax Number	:	570-387-2287

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	02/16/2018

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Directions to “ DAVID JOSEPH BALL DO” Practice Location

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