Provider Demographics
NPI:1982176657
Name:C B PODIATRIC SERVICES
Entity Type:Organization
Organization Name:C B PODIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:270-421-7754
Mailing Address - Street 1:108 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-1728
Mailing Address - Country:US
Mailing Address - Phone:270-421-7754
Mailing Address - Fax:
Practice Address - Street 1:108 CARDINAL DR
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-1728
Practice Address - Country:US
Practice Address - Phone:270-888-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty