Healthcare Provider Details

I. General information

NPI: 1902286743
Provider Name (Legal Business Name): DONALD FORD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2015
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 DON WICKHAM DR
CLERMONT FL
34711-1979
US

IV. Provider business mailing address

1900 DON WICKHAM DR
CLERMONT FL
34711-1979
US

V. Phone/Fax

Practice location:
  • Phone: 352-536-8840
  • Fax:
Mailing address:
  • Phone: 352-536-8840
  • Fax: 352-536-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number080840
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberUO 4532
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS22069
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number80840
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: