Healthcare Provider Details

I. General information

NPI: 1306374616
Provider Name (Legal Business Name): JOHN PAUL FORD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H20N GOULD ST STE R
SHERIDAN WY
82801
US

IV. Provider business mailing address

H20N GOULD ST STE R
SHERIDAN WY
82801
US

V. Phone/Fax

Practice location:
  • Phone: 801-390-8463
  • Fax: 800-805-7962
Mailing address:
  • Phone: 940-548-3362
  • Fax: 800-805-7962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02006420A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02006420A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: