1093709297 NPI number — DR. PATRICK J WARD MD

Table of content: DR. PATRICK J WARD MD (NPI 1093709297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093709297 NPI number — DR. PATRICK J WARD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARD
Provider First Name:
PATRICK
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093709297
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5053 WOOSTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45226-2326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-751-2145
Provider Business Mailing Address Fax Number:
513-751-2138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4350 MALSBARY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242-5621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-751-2273
Provider Business Practice Location Address Fax Number:
513-792-5844
Provider Enumeration Date:
09/02/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  35075469 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RH0003X , with the licence number: 38228 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 64062110 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200410410 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2407096 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".