Provider Demographics
NPI:1932858057
Name:WARD, TAYLOR EZRA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:EZRA
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 E FEATHER VIEW CT
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6699
Mailing Address - Country:US
Mailing Address - Phone:206-427-1344
Mailing Address - Fax:
Practice Address - Street 1:1460 E FEATHER VIEW CT
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6699
Practice Address - Country:US
Practice Address - Phone:206-427-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program