Provider Demographics
NPI:1457747370
Name:WARD, REBECCA JANE (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:WARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-932-6150
Mailing Address - Fax:816-932-1786
Practice Address - Street 1:4320 WORNALL RD STE 336
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5963
Practice Address - Country:US
Practice Address - Phone:816-932-6150
Practice Address - Fax:816-932-1786
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2019031895207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program