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General NPI Number Information
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NPI Number | 1922484708
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Entity Type | Individual
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Provider Name | WILLIAM JASON WARD O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 100 WALMART DR
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-5548
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Country | US
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Telephone | 270-737-0055
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Fax | 270-763-0050
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Provider Business Mailing Address
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Address Line | 4934 UPTON TALLEY RD
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City | UPTON
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State | KY
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Zip | 42784-9336
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Country | US
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Telephone | 270-737-0055
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Fax | 270-763-0050
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2003DT
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License Number State | KY
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