Provider Demographics
NPI:1982672077
Name:BALL, ARTHUR GEORGE (PA)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:GEORGE
Last Name:BALL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 COLSON AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-7607
Mailing Address - Country:US
Mailing Address - Phone:941-373-7844
Mailing Address - Fax:941-373-7856
Practice Address - Street 1:2400 COLSON AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-7607
Practice Address - Country:US
Practice Address - Phone:941-373-7844
Practice Address - Fax:941-373-7856
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3613363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS77985Medicare UPIN
FLE2392BMedicare ID - Type UnspecifiedMEDICARE