Provider Demographics
NPI:1578813655
Name:BALL, JAMIE JON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:JON
Last Name:BALL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8080 PARK MEADOWS DR.
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2558
Mailing Address - Country:US
Mailing Address - Phone:303-346-8828
Mailing Address - Fax:303-346-0407
Practice Address - Street 1:8080 PARK MEADOWS DR.
Practice Address - Street 2:
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2558
Practice Address - Country:US
Practice Address - Phone:303-346-8828
Practice Address - Fax:303-346-0407
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO3443363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant