Healthcare Provider Details

I. General information

NPI: 1922636174
Provider Name (Legal Business Name): LUKE TYLER BALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 WE KNIGHT DR
FORT SMITH AR
72903-6254
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 479-709-6700
  • Fax: 479-709-6710
Mailing address:
  • Phone: 479-709-6700
  • Fax: 479-709-6710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2025012594
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE-20688
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: