Provider Demographics
NPI:1285627091
Name:WARD, BRADLEY JASON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JASON
Last Name:WARD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:21 SAYRE CT
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-7085
Mailing Address - Country:US
Mailing Address - Phone:606-776-3958
Mailing Address - Fax:606-849-2633
Practice Address - Street 1:209 S MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-1203
Practice Address - Country:US
Practice Address - Phone:606-845-2101
Practice Address - Fax:606-849-2633
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY012973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist