Provider Demographics
NPI:1841454477
Name:BALL, ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BALL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19621 COCHRAN BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-2070
Mailing Address - Country:US
Mailing Address - Phone:941-627-9095
Mailing Address - Fax:941-629-6993
Practice Address - Street 1:19621 COCHRAN BLVD
Practice Address - Street 2:UNIT #1
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2070
Practice Address - Country:US
Practice Address - Phone:941-627-9095
Practice Address - Fax:941-629-6993
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY250413-1207LP2900X
NJ25MB08733400207LP2900X
FLOS 11245208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine