Healthcare Provider Details

I. General information

NPI: 1023563996
Provider Name (Legal Business Name): ROBERT BALL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E MARKET ST
AKRON OH
44305-2421
US

IV. Provider business mailing address

725 E MARKET ST
AKRON OH
44305-2421
US

V. Phone/Fax

Practice location:
  • Phone: 330-434-4141
  • Fax: 330-315-1112
Mailing address:
  • Phone: 330-434-4141
  • Fax: 330-315-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number#RN196007
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: