Healthcare Provider Details

I. General information

NPI: 1548529209
Provider Name (Legal Business Name): CHAD EVERETT WARD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHAD EVERETT WARD DO

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 4TH ST
BRUNSWICK GA
31520-3779
US

IV. Provider business mailing address

3300 4TH ST
BRUNSWICK GA
31520-3779
US

V. Phone/Fax

Practice location:
  • Phone: 912-466-5870
  • Fax: 912-466-5883
Mailing address:
  • Phone: 912-466-5870
  • Fax: 912-466-5883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number15138
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number94415
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: