MEDICARE: JOHN J BALL MD

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
1	207V00000X	Obstetrics & Gynecology Physician	22214	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083609770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J BALL MD

Provider Business Mailing Address
First Line	:	379 HOSPITAL BLVD
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2080
Country	:	US
Telephone Number	:	731-660-3344
Fax Number	:	731-660-3347

Provider Business Practice Location Address
First Line	:	379 HOSPITAL BLVD
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2080
Country	:	US
Telephone Number	:	731-660-3344
Fax Number	:	731-660-3347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	07/20/2020

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