Provider Demographics
NPI:1659444735
Name:WARD, WILL W JR (MD)
Entity Type:Individual
Prefix:
First Name:WILL
Middle Name:W
Last Name:WARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-969-6552
Mailing Address - Fax:502-212-1358
Practice Address - Street 1:825 BARRET AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1743
Practice Address - Country:US
Practice Address - Phone:502-540-7200
Practice Address - Fax:502-540-7209
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY13090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64325004Medicaid