Provider Demographics
NPI:1477724623
Name:BALL, CHAD G (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:G
Last Name:BALL
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 PEACHTREE ST NE
Mailing Address - Street 2:#1017
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1249
Mailing Address - Country:US
Mailing Address - Phone:404-518-2071
Mailing Address - Fax:
Practice Address - Street 1:69 JESSE HILL JR DRIVE
Practice Address - Street 2:SUITE 302, GLENN MEMORIAL BLDG.
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059120282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital