Provider Demographics
NPI:1497031595
Name:WARD, DAVID R (BS, HIS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:WARD
Suffix:
Gender:M
Credentials:BS, HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S RIVER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2155
Mailing Address - Country:US
Mailing Address - Phone:435-673-8743
Mailing Address - Fax:435-634-9000
Practice Address - Street 1:616 S RIVER RD STE 210
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2155
Practice Address - Country:US
Practice Address - Phone:435-673-8743
Practice Address - Fax:435-634-9000
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT291503-4602237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist