Basic Information
| Provider Information | |||||||||
| NPI: | 1942288386 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALL | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2118 SPRING VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175440150 | ||||||||
| FaxNumber: | 7175440151 | ||||||||
| Practice Location | |||||||||
| Address1: | 2118 SPRING VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175440150 | ||||||||
| FaxNumber: | 7175440151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2006 | ||||||||
| LastUpdateDate: | 07/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | D0054495 | MD | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD047303L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 254602700 | 05 | MD | MEDICAID |