Healthcare Provider Details

I. General information

NPI: 1952641664
Provider Name (Legal Business Name): JOSIAH BENJAMIN WARD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 SUNSET DR STE E
LA GRANDE OR
97850-1200
US

IV. Provider business mailing address

PO BOX 3290 PO BOX 3290
LA GRANDE OR
97850-7290
US

V. Phone/Fax

Practice location:
  • Phone: 541-663-3150
  • Fax: 541-975-5111
Mailing address:
  • Phone: 541-963-8421
  • Fax: 541-963-1476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO226472
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1432
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: