MEDICARE: ELIZABETH A BALL O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	13207	CA

General Provider Information

NPI Number	:	1548473390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A BALL O.D.

Provider Business Mailing Address
First Line	:	6870 S RAINBOW BLVD STE 109-110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2106
Country	:	US
Telephone Number	:	702-833-1260
Fax Number	:	702-614-4829

Provider Business Practice Location Address
First Line	:	6870 S RAINBOW BLVD STE 109-110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2106
Country	:	US
Telephone Number	:	702-833-1260
Fax Number	:	702-614-4829

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/10/2021

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