MEDICARE: WARD G. GYPSON III

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	208100000X	Physical Medicine & Rehabilitation Physician	0101237358	VA

General Provider Information

NPI Number	:	1518036144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARD G. GYPSON III

Provider Business Mailing Address
First Line	:	PO BOX 9007
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22906-9007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 RAY C HUNT DR STE 3100
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22903-2980
Country	:	US
Telephone Number	:	434-243-3633
Fax Number	:	434-243-1539

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/09/2023

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