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General NPI Number Information
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NPI Number | 1245370246
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Entity Type | Organization
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Legal Business Name | KATHRYN L FORD FAMILY PRACTICE CENTER, L.L.C.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 870 SOUTH GOVENORS AVE.
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City | DOVER
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State | DE
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Zip | 19904-4108
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Country | US
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Telephone | 302-674-8088
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Fax | 302-674-8213
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Provider Business Mailing Address
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Address Line | 870 SOUTH GOVENORS AVE.
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City | DOVER
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State | DE
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Zip | 19904-4108
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Country | US
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Telephone | 302-674-8088
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Fax | 302-674-8213
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | PAUL WENDELL FORD JR.
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Credential | M.D.
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Telephone | 302-674-8088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C1-0002538
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License Number State | DE
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