Healthcare Provider Details

I. General information

NPI: 1003248741
Provider Name (Legal Business Name): EUGENE A WARD M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 E FLETCHER AVENUE SUITE 310
TAMPA FL
33613-4659
US

IV. Provider business mailing address

3450 E FLETCHER AVENUE SUITE 310
TAMPA FL
33613-4659
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-1654
  • Fax: 813-972-7176
Mailing address:
  • Phone: 813-972-1654
  • Fax: 813-972-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. EUGENE A WARD
Title or Position: MD
Credential: M.D.
Phone: 813-972-1654