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NPI Code Detail

MEDICARE: JOHN HAROLD BALL PA-C

MEDICARE: JOHN HAROLD BALL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant349321-1206UT

General Provider Information

NPI Number : 1003975145
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN HAROLD BALL PA-C
Provider Business Mailing Address
First Line : 395 W BULLDOG BLVD STE 401
Second Line :
City : PROVO
State : UT
Zip : 84604-3338
Country : US
Telephone Number : 801-357-7546
Fax Number : 801-357-8840
Provider Business Practice Location Address
First Line : 395 W BULLDOG BLVD STE 401
Second Line :
City : PROVO
State : UT
Zip : 84604-3338
Country : US
Telephone Number : 801-357-7546
Fax Number : 801-357-8840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/09/2019

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Directions to “ JOHN HAROLD BALL PA-C” Practice Location

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