Individual
MS. AUDRA SUZANNE BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
4805 E HIGHWAY 37, TUTTLE, OK 73089-8791
(405) 381-9979
(405) 381-9130
Mailing address
4805 E HIGHWAY 37, TUTTLE, OK 73089-8791
(405) 381-9979
(405) 381-9130
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200110730A
—
OK
Enumeration date
01/31/2007
Last updated
02/12/2009
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