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NPI 1255146148

NPI 1255146148 : TYLER B WARD : LEXINGTON, KY

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General NPI Number Information
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    NPI Number           |    1255146148
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    Entity Type          |    Individual 
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    Provider Name        |    TYLER B WARD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/10/2025
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    Last Update Date     |    02/10/2025
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Provider Practice Location Address
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    Address Line         |    1868 PLAUDIT PL STE B 
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    City                 |    LEXINGTON
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    State                |    KY
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    Zip                  |    40509-2429
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    Country              |    US
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    Telephone            |    859-264-0512
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1650 LYNDON FARM CT STE 300 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40223-5005
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    Country              |    US
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    Telephone            |    726-202-3039
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    Fax                  |    210-978-5592
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    009280
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    License Number State |    KY
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