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NPI Code Detail

MEDICARE: DR. JODIE KEVIN WARD DDS

MEDICARE:  DR. JODIE KEVIN WARD  DDS
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
11223G0001XGeneral Practice Dentistry3109WV

General Provider Information

NPI Number : 1922150457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JODIE KEVIN WARD DDS
Provider Business Mailing Address
First Line : 71 COWARDLY LION DR SUITE C
Second Line :
City : HEDGESVILLE
State : WV
Zip : 25427-6779
Country : US
Telephone Number : 304-754-9008
Fax Number : 304-754-0098
Provider Business Practice Location Address
First Line : 71 COWARDLY LION DR STE C
Second Line :
City : HEDGESVILLE
State : WV
Zip : 25427-6779
Country : US
Telephone Number : 304-754-9008
Fax Number : 304-754-0098
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JODIE KEVIN WARD DDS” Practice Location

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