Basic Information
Provider Information
NPI: 1982812491
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALL
FirstName: MOLLY
MiddleName: KATHERINE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 CHILDRENS DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber: 6147222000
FaxNumber: 6147224541
Practice Location
Address1: 555 S 18TH ST
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432052654
CountryCode: US
TelephoneNumber: 6147226200
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2007
LastUpdateDate: 02/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001X3515089OHY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

ID Information
IDTypeStateIssuerDescription
011147805OH MEDICAID


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