Provider Demographics
NPI:1104125764
Name:BALL, ALISON G (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:G
Last Name:BALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1405 FRANKLIN GTWY SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8721
Mailing Address - Country:US
Mailing Address - Phone:770-951-5400
Mailing Address - Fax:678-388-1399
Practice Address - Street 1:1405 FRANKLIN GTWY SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8721
Practice Address - Country:US
Practice Address - Phone:770-951-5400
Practice Address - Fax:678-388-1399
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA72244208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003149128CMedicaid