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General NPI Number Information
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NPI Number | 1902861966
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES BALLING M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 119 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-5779
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Country | US
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Telephone | 813-571-5150
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 MARBLE CREST DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-6081
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Country | US
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Telephone | 813-949-5209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 00022749
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME95813
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License Number State | FL
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