Provider Demographics
NPI:1508116278
Name:ONCALL MOBILE MEDICAL AND WELLNESS PLLC
Entity Type:Organization
Organization Name:ONCALL MOBILE MEDICAL AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO, MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-747-2262
Mailing Address - Street 1:6428 W WILKINSON BLVD
Mailing Address - Street 2:SUITE 241
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2858
Mailing Address - Country:US
Mailing Address - Phone:704-747-2262
Mailing Address - Fax:877-934-7633
Practice Address - Street 1:6428 W WILKINSON BLVD
Practice Address - Street 2:SUITE 241
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2858
Practice Address - Country:US
Practice Address - Phone:704-747-2262
Practice Address - Fax:877-934-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty