Individual
CHUCK L BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101250915
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821253535
—
VA
01
—
VAD000
FEDERAL UPIN
TN
01
—
VV4469
MEDICARE
VA
Enumeration date
07/22/2008
Last updated
07/15/2025
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