MEDICARE: SAMUEL E WARD MD PL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35511	OTHER		BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255319695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL E WARD MD PL

Provider Business Mailing Address
First Line	:	3803 GALILEE RD
Second Line	:
City	:	GRACEVILLE
State	:	FL
Zip	:	32440-4721
Country	:	US
Telephone Number	:	850-547-3679
Fax Number	:	855-492-6785

Provider Business Practice Location Address
First Line	:	3607 ROCHE AVE
Second Line	:
City	:	VERNON
State	:	FL
Zip	:	32462-3358
Country	:	US
Telephone Number	:	850-547-3679
Fax Number	:	855-492-6785

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JESSICA JEAN HAWKINS
Credential	:
Telephone Number	:	850-547-3679

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	09/11/2023

Similar Medicare Providers

1063497972 — VERNON DISCOUNT DRUG INC
Practice Location Address:

3248 MAIN ST
VERNON, FL
32462-2223

Practice Phone: 850-535-2803
Practice Fax: 850-535-2803

1437187440 — MRS. HELENA COSBY-GARCIA MS LMHC
Practice Location Address:

3134 MOSS HILL RD
VERNON, FL
32462

Practice Phone: 850-624-5634
Practice Fax: 850-535-5028

1417077827 — MICHAEL D NISSEN N.P.-C
Practice Location Address:

3399 FERRIS CIR
VERNON, FL
32462-2217

Practice Phone: 706-594-6919
Practice Fax:

1275706087 — MRS. JESSICA LYNN MAHAFFEY
Practice Location Address:

2829 YELLOW JACKET DR
VERNON, FL
32462-2011

Practice Phone: 850-625-9501
Practice Fax: 850-388-1220

1851545115 — DAWN RENE LLC
Practice Location Address:

3027 MAIN ST
VERNON, FL
32462-2220

Practice Phone: 850-535-0703
Practice Fax:

1326351545 — HOLMES CREEK ASSISTED LIVING FACILITY, INC.
Practice Location Address:

3732 ROCHE AVE
VERNON, FL
32462-3373

Practice Phone: 850-535-1160
Practice Fax: 850-535-4713

Directions to “SAMUEL E WARD MD PL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.