MEDICARE: CODY SCOTT WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3207	OK

General Provider Information

NPI Number	:	1184364093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY SCOTT WARD

Provider Business Mailing Address
First Line	:	23522 230TH ST.
Second Line	:
City	:	FERGUS FALLS
State	:	MN
Zip	:	56537
Country	:	US
Telephone Number	:	218-205-7875
Fax Number	:

Provider Business Practice Location Address
First Line	:	10010 E 81ST ST STE 100
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-4558
Country	:	US
Telephone Number	:	918-444-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	09/25/2022

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Directions to “ CODY SCOTT WARD ” Practice Location

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