Provider Demographics
NPI:1427345263
Name:BALL, ALISON JULIETE (DO)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:JULIETE
Last Name:BALL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2223 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 40
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7272
Mailing Address - Country:US
Mailing Address - Phone:636-755-4400
Mailing Address - Fax:
Practice Address - Street 1:2223 TECHNOLOGY DR
Practice Address - Street 2:SUITE 40
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7272
Practice Address - Country:US
Practice Address - Phone:636-755-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013030576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1427345263Medicaid
MO501570054Medicare PIN