Organization
PEDIATRIC ASSOCIATES OF ELIZABETHTOWN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARQUITA H BALL M.D. (PARTNER)
(270) 737-4808
Entity
Organization
Contact information
Practice address
111 HELMWOOD PLAZA DR, ELIZABETHTOWN, KY 42701-2480
(270) 737-4808
Mailing address
111 HELMWOOD PLAZA DR, ELIZABETHTOWN, KY 42701-2480
(270) 737-4808
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1054638
PASSPORT GROUP NUMBER
KY
05
—
65929457
—
KY
Enumeration date
12/12/2006
Last updated
07/19/2024
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