Healthcare Provider Details

I. General information

NPI: 1093646408
Provider Name (Legal Business Name): DEVAN WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 KING ARTHUR DR
FRANKLIN IN
46131-9060
US

IV. Provider business mailing address

117 KING ARTHUR DR
FRANKLIN IN
46131-9060
US

V. Phone/Fax

Practice location:
  • Phone: 317-590-9775
  • Fax: 317-690-9775
Mailing address:
  • Phone: 317-590-9775
  • Fax: 317-690-9775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: