Organization
CONNIE BALL MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE SUE BALL (PHYSICIAN OWNER)
(937) 748-5346
Entity
Organization
Contact information
Practice address
84 N MAIN ST, SPRINGBORO, OH 45066
(937) 748-5346
(937) 748-5369
Mailing address
84 N MAIN ST, SPRINGBORO, OH 45066
(937) 748-5346
(937) 748-5369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35067559
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000338258
ANTHEM
—
01
—
0112593
UNITED HEALTH CARE
—
05
—
0168894
—
OH
01
—
363899941026
CARESOURCE
—
01
—
3996090680
WORKERS COMPENSATION
—
01
—
399609068003
MEDICAL MUTUAL
—
01
—
5668002
AETNA
—
01
—
D67559
HUMANA
—
01
—
DE3333
RR MCR
—
01
—
P00286099
RR MCR
—
Enumeration date
08/14/2007
Last updated
04/20/2008
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