Provider Demographics
NPI:1225020175
Name:BALL, GEORGE CHRISTOPHER (MD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:CHRISTOPHER
Last Name:BALL
Suffix:
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 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5391
Mailing Address - Fax:601-984-6904
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:DEPT OF OB-GYN
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5306
Practice Address - Fax:601-984-6904
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS09597207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1771767Medicaid
MS0013476Medicaid
AL196086Medicaid
AL196086Medicaid
MS0013476Medicaid
MS379081YS8TMedicare PIN
MSP01526119Medicare PIN
MSE99519Medicare UPIN
MS072833650779-000001Medicare PIN