Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD448953 | PA |
NPI | 1205265972 |
---|---|
Provider Name | Dr. Allison Laura Ball |
First Address | Wilkes Barre, PA 18711-0027 |
Second Address | Wilkes Barre, PA 18711-0027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2013 |
Last Update Date | 04/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158446 | CDIP (01) |