Doctor Name: | RUSSELL A. BALL |
NPI Number: | 1336134782 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 9901503 |
Business Practice Address: | 2006 New Garden Rd Suite 106 Greensboro, NC - 274102566 |
Business Phone Number: | 3366096240 |
Business Fax Number: | 3366096238 |
Mailing Address: | 2006 New Garden Rd, Suite 106 GREENSBORO |
State: | NC |
Postal Code: | 274102566 |
Phone Number: | 3366096240 |
Fax Number: | 3366096238 |
NPI Enumeration Date: | 09/13/2005 |
NPI Last Update Date: | 04/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 9901503 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |