Provider Demographics
NPI:1669775995
Name:WARD, DARYLL K (NREMT-P)
Entity type:Individual
Prefix:
First Name:DARYLL
Middle Name:K
Last Name:WARD
Suffix:
Gender:M
Credentials:NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347794 E 980 RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:OK
Mailing Address - Zip Code:74869-9092
Mailing Address - Country:US
Mailing Address - Phone:918-866-2541
Mailing Address - Fax:
Practice Address - Street 1:347794 E 980 RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:OK
Practice Address - Zip Code:74869-9092
Practice Address - Country:US
Practice Address - Phone:918-866-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13292146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic