Provider Demographics
NPI:1457878985
Name:BALL, JULIA ROSE (DMSC MPAS PA-C)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ROSE
Last Name:BALL
Suffix:
Gender:F
Credentials:DMSC MPAS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-2905
Mailing Address - Country:US
Mailing Address - Phone:850-481-1101
Mailing Address - Fax:
Practice Address - Street 1:1514 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2905
Practice Address - Country:US
Practice Address - Phone:850-481-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110651363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPA.0007787OtherSTATE LICENSE
WAPA.61406579OtherSTATE LICENSE
WVITRPA-1021OtherSTATE LICENSE - TELEHEATH
UT13242146-1206OtherSTATE LICENSE
FLPA9110651OtherSTATE LICENSE