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General NPI Number Information
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NPI Number | 1497901524
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Entity Type | Organization
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Legal Business Name | EDWARD D. BALL D.O., P.C.
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 313 S. CLINTON
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City | GRAND LEDGE
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State | MI
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Zip | 48837
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Country | US
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Telephone | 517-627-2303
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Fax | 517-622-2295
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Provider Business Mailing Address
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Address Line | PO BOX 313
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City | GRAND LEDGE
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State | MI
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Zip | 48837
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Country | US
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Telephone | 517-627-2303
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Fax | 517-622-2295
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. TAMARA J MCKAY
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Credential |
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Telephone | 517-627-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | EB006567
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License Number State | MI
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