Provider Demographics
NPI:1356337307
Name:WARD, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 US HIGHWAY 66 E
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-2755
Mailing Address - Country:US
Mailing Address - Phone:812-547-3447
Mailing Address - Fax:812-547-9543
Practice Address - Street 1:109 US HIGHWAY 66 E
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-2755
Practice Address - Country:US
Practice Address - Phone:812-547-3447
Practice Address - Fax:812-547-9543
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000242955OtherANTHEM BC/BS
IN100203010AMedicaid
IN15D1005855OtherCLIA
080194390OtherRAILROAD MEDICARE
KY64344591Medicaid
KY64344591Medicaid
KY64344591Medicaid
IN100203010AMedicaid