Healthcare Provider Details

I. General information

NPI: 1295420255
Provider Name (Legal Business Name): ALEXA BALL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-1000
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-3895
  • Fax:
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101029268
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: