Individual
JACE ALLEN BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
621 3RD ST S, GLASGOW, MT 59230-2604
(406) 228-3645
(406) 228-3533
Mailing address
221 5TH AVE S, GLASGOW, MT 59230-2600
(406) 228-3400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
591
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000902403
BCBS-MT
MT
01
—
1134455835
MEDICARE
MT
05
—
1134455835
—
MT
Enumeration date
10/30/2009
Last updated
11/23/2020
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