Healthcare Provider Details

I. General information

NPI: 1235916743
Provider Name (Legal Business Name): JAMES CHRISTOPHER BALL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 POST OAK RD
BELVIDERE TN
37306-2413
US

IV. Provider business mailing address

1275 POST OAK RD
BELVIDERE TN
37306-2413
US

V. Phone/Fax

Practice location:
  • Phone: 931-636-3219
  • Fax:
Mailing address:
  • Phone: 931-636-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: