Provider Demographics
NPI:1871590232
Name:BALL, JAMES B JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:BALL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16043 BELLA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-5133
Mailing Address - Country:US
Mailing Address - Phone:813-972-7105
Mailing Address - Fax:
Practice Address - Street 1:7050 GALL BLVD
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-1347
Practice Address - Country:US
Practice Address - Phone:813-779-6302
Practice Address - Fax:813-783-6116
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME487262085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043317900Medicaid
FL02132OtherBCBS OF FLORIDA
FL02132WMedicare ID - Type Unspecified
FLC02846Medicare UPIN