MEDICARE: DR. JILL ANGELA WARD MD

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	207P00000X	Emergency Medicine Physician	110689	FL
2	207P00000X	Emergency Medicine Physician	5307014169	MI
3	207P00000X	Emergency Medicine Physician	FW2754655	FL
4	207P00000X	Emergency Medicine Physician	4301507937	MI
5	207P00000X	Emergency Medicine Physician	93636	GA
6	207P00000X	Emergency Medicine Physician	7171452	ID
7	207P00000X	Emergency Medicine Physician	5315241184	MI
8	207P00000X	Emergency Medicine Physician	01093912A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14PL3	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538441316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL ANGELA WARD MD

Provider Business Mailing Address
First Line	:	7829 COLLINS GROVE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7176
Country	:	US
Telephone Number	:	904-535-4815
Fax Number	:

Provider Business Practice Location Address
First Line	:	5816 N SHELDON RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3153
Country	:	US
Telephone Number	:	858-775-1700
Fax Number	:

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

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	06/30/2025

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