Provider Demographics
NPI:1659661478
Name:WARD, JASON SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:SCOTT
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:6401 FRANCE AVE S
Mailing Address - Street 2:FAIRVIEW SOUTHDALE HOSPITAL
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2199
Mailing Address - Country:US
Mailing Address - Phone:952-924-8463
Mailing Address - Fax:952-924-8358
Practice Address - Street 1:6401 FRANCE AVE S
Practice Address - Street 2:FAIRVIEW SOUTHDALE HOSPITAL
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2199
Practice Address - Country:US
Practice Address - Phone:952-924-8463
Practice Address - Fax:952-924-8358
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN57934207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine