MEDICARE: DR. THOMAS BALL JR. DPM

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	213E00000X	Podiatrist	5901001013	MI

General Provider Information

NPI Number	:	1275559338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS BALL JR. DPM

Provider Business Mailing Address
First Line	:	37506 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3511
Country	:	US
Telephone Number	:	586-438-2672
Fax Number	:	586-438-2678

Provider Business Practice Location Address
First Line	:	37506 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3511
Country	:	US
Telephone Number	:	586-438-2672
Fax Number	:	586-438-2678

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	01/09/2012

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