Healthcare Provider Details

I. General information

NPI: 1235186214
Provider Name (Legal Business Name): DENIS W WARD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 6TH ST SW OHIO HOSPITAL BASED PHYSICIAN CORP
CANTON OH
44710
US

IV. Provider business mailing address

2600 6TH ST SW OHIO HOSPITAL BASED PHYSICIAN CORP
CANTON OH
44710
US

V. Phone/Fax

Practice location:
  • Phone: 330-363-7462
  • Fax: 330-363-7679
Mailing address:
  • Phone: 330-363-7462
  • Fax: 330-363-7679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4565
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: