Provider Demographics
NPI:1306643366
Name:WARD, RONALD LEE
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:LEE
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 1:4601 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3860
Mailing Address - Country:US
Mailing Address - Phone:501-664-0769
Mailing Address - Fax:501-664-9558
Practice Address - Street 1:4601 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3860
Practice Address - Country:US
Practice Address - Phone:501-664-0769
Practice Address - Fax:501-664-9558
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR120059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily