Healthcare Provider Details

I. General information

NPI: 1922587591
Provider Name (Legal Business Name): ASHLYN WARD OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLYN DEHOOGH

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 09/20/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 86TH ST
URBANDALE IA
50322-4309
US

IV. Provider business mailing address

2699 86TH ST
URBANDALE IA
50322-4309
US

V. Phone/Fax

Practice location:
  • Phone: 515-270-2490
  • Fax:
Mailing address:
  • Phone: 515-270-2490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046011231
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number126441
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: