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General NPI Number Information
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NPI Number | 1972567451
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Entity Type | Individual
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Provider Name | RANDALL BALL PA
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 2700 OLD ROSEBUD RD STE 110
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City | LEXINGTON
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State | KY
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Zip | 40509-8624
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Country | US
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Telephone | 859-257-6200
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Fax | 859-257-1172
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Provider Business Mailing Address
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Address Line | 2412 RING RD SUITE 100
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-5912
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Country | US
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Telephone | 270-737-2273
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Fax | 270-735-9087
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA241
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA241
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA241
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License Number State | KY
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