MEDICARE: DR. JOHN MICHAEL WARD D.O.

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	31656	MO

General Provider Information

NPI Number	:	1427057793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MICHAEL WARD D.O.

Provider Business Mailing Address
First Line	:	306 MAIN ST
Second Line	:
City	:	BOONVILLE
State	:	MO
Zip	:	65233-1566
Country	:	US
Telephone Number	:	660-882-2451
Fax Number	:	660-882-2434

Provider Business Practice Location Address
First Line	:	306 MAIN ST
Second Line	:
City	:	BOONVILLE
State	:	MO
Zip	:	65233-1566
Country	:	US
Telephone Number	:	660-882-2451
Fax Number	:	660-882-2434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/20/2015

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