Provider Demographics
NPI:1063040434
Name:WARD, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 FARSON ST STE 203A
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1069
Mailing Address - Country:US
Mailing Address - Phone:740-401-1930
Mailing Address - Fax:740-401-1937
Practice Address - Street 1:807 FARSON ST STE 203A
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1069
Practice Address - Country:US
Practice Address - Phone:740-401-1930
Practice Address - Fax:740-401-1937
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.147094207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine