Provider Demographics
NPI:1902824683
Name:WARD, FELICIA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:MICHELLE
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:MARINGOUIN
Mailing Address - State:LA
Mailing Address - Zip Code:70757-0099
Mailing Address - Country:US
Mailing Address - Phone:225-802-5769
Mailing Address - Fax:
Practice Address - Street 1:10350 HIGHWAY 977
Practice Address - Street 2:
Practice Address - City:MARINGOUIN
Practice Address - State:LA
Practice Address - Zip Code:70757
Practice Address - Country:US
Practice Address - Phone:225-802-5769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25991208M00000X
LAMD. 025991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1050563Medicaid
LA1050563Medicaid
I39769Medicare UPIN