Individual
KENNETH C BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, DEPT OF MEDICINE DIVISION OF GENERAL INTERNAL MEDICINE, JACKSON, MS 39216-4500
(601) 984-5660
(601) 984-6870
Mailing address
2500 N STATE ST, HOSPITALIST, JACKSON, MS 39216-4500
(601) 984-4934
(601) 984-6870
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18088
MS
208M00000X
Hospitalist Physician
Primary
18088
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06807331
—
MS
01
—
P01105179
RAILROAD MEDICARE
MS
Enumeration date
08/09/2006
Last updated
04/09/2014
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