Healthcare Provider Details

I. General information

NPI: 1710541354
Provider Name (Legal Business Name): RACHEL WARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVE STE 447
MEMPHIS TN
38103-3438
US

IV. Provider business mailing address

1118 ROSS CLARK CIR STE 100
DOTHAN AL
36301-3027
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5814
  • Fax:
Mailing address:
  • Phone: 334-794-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number65222
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: