Provider Demographics
NPI:1326013640
Name:BALL, JOHN J III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:BALL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4374 NEW TOWN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2865
Mailing Address - Country:US
Mailing Address - Phone:757-220-2795
Mailing Address - Fax:757-259-8797
Practice Address - Street 1:502 STRAWBERRY PLAINS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-220-2795
Practice Address - Fax:757-259-8797
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101028243207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010112036Medicaid
VA010112036Medicaid
006242S33Medicare ID - Type Unspecified