Individual
BLAIR ANDREW BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15235 N DYSART RD, EL MIRAGE, AZ 85335-9738
(602) 569-3999
(602) 569-3887
Mailing address
1533 E WILLETTA ST, PHOENIX, AZ 85006-2935
(602) 569-3999
(602) 569-3887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57937
ID
363LF0000X
Family Nurse Practitioner
Primary
AP11340
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421665
—
AZ
Enumeration date
03/06/2018
Last updated
02/03/2020
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