Provider Demographics
NPI:1003248741
Name:EUGENE A WARD M.D. PA
Entity Type:Organization
Organization Name:EUGENE A WARD M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-972-1654
Mailing Address - Street 1:3450 E FLETCHER AVENUE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4659
Mailing Address - Country:US
Mailing Address - Phone:813-972-1654
Mailing Address - Fax:813-972-7176
Practice Address - Street 1:3450 E FLETCHER AVENUE
Practice Address - Street 2:SUITE 310
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4659
Practice Address - Country:US
Practice Address - Phone:813-972-1654
Practice Address - Fax:813-972-7176
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EUGENE A WARD M.D. PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RG0100X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068946700Medicaid
FLD54093Medicare UPIN
30707Medicare PIN