MEDICARE: JOHN M. WARD, D.O., P.C.

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	208D00000X	General Practice Physician	31656	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225358641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN M. WARD, D.O., P.C.

Provider Business Mailing Address
First Line	:	306 MAIN ST
Second Line	:
City	:	BOONVILLE
State	:	MO
Zip	:	65233-1566
Country	:	US
Telephone Number	:	660-882-2451
Fax Number	:	660-882-2434

Provider Business Practice Location Address
First Line	:	306 MAIN ST
Second Line	:
City	:	BOONVILLE
State	:	MO
Zip	:	65233-1566
Country	:	US
Telephone Number	:	660-882-2451
Fax Number	:	660-882-2434

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN M WARD
Credential	:	D.O.
Telephone Number	:	660-882-2451

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	06/08/2010

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