Provider Demographics
NPI:1568595890
Name:WARD, ROBERT MICHAEL (MS, FAAA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:WARD
Suffix:
Gender:M
Credentials:MS, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E CHICKASAW AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5347
Mailing Address - Country:US
Mailing Address - Phone:918-426-4742
Mailing Address - Fax:918-423-2466
Practice Address - Street 1:231 E CHICKASAW AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5347
Practice Address - Country:US
Practice Address - Phone:918-426-4742
Practice Address - Fax:918-423-2466
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK94231HA2500X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200125780Medicaid
OK100669410Medicaid