Provider Demographics
NPI:1003864893
Name:BALL, JAMES BRADLEY (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADLEY
Last Name:BALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1210 S CEDAR CREST BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6265
Practice Address - Country:US
Practice Address - Phone:610-402-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO460042080P0207X, 208000000X
AL256292080P0207X
CODR.0046004207PP0204X
PAMD487761C2080P0207X
TN701312080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37428764Medicaid
NE10025570100Medicaid
WY1003864893Medicaid
AL113679Medicaid
WY132927800Medicaid
NM92281371Medicaid
AL009935727Medicaid
SD7756690Medicaid
CO473240ZS40Medicare PIN
WY132927800Medicaid