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NPI Code Detail

MEDICARE: JAMIE LEE BALL

MEDICARE: JAMIE LEE BALL
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1477387900
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE LEE BALL
Provider Business Mailing Address
First Line : 2320 S JACKSON AVE APT 40A
Second Line :
City : TULSA
State : OK
Zip : 74107-3057
Country : US
Telephone Number : 918-313-6652
Fax Number :
Provider Business Practice Location Address
First Line : 2320 S JACKSON AVE APT 40A
Second Line :
City : TULSA
State : OK
Zip : 74107-3057
Country : US
Telephone Number : 918-313-6652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2024
Last Update Date : 08/28/2024

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Directions to “ JAMIE LEE BALL ” Practice Location

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