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NPI Code Detail

MEDICARE: JEFFREY A. BALL M.D.

MEDICARE: JEFFREY A. BALL M.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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianMD21254ME

General Provider Information

NPI Number : 1639515711
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY A. BALL M.D.
Provider Business Mailing Address
First Line : 35 MILES ST
Second Line :
City : DAMARISCOTTA
State : ME
Zip : 04543-4047
Country : US
Telephone Number : 207-563-4146
Fax Number : 207-563-3717
Provider Business Practice Location Address
First Line : 592 WEST MAIN STREET
Second Line :
City : WALDOBORO
State : ME
Zip : 04572-6023
Country : US
Telephone Number : 207-832-6394
Fax Number : 207-832-4392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2013
Last Update Date : 12/19/2016

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Directions to “ JEFFREY A. BALL M.D.” Practice Location

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