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NPI Code Detail

MEDICARE: JASON SCOTT WARD M.D.

MEDICARE: JASON SCOTT WARD M.D.
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
1207R00000XInternal Medicine Physician57934MN

General Provider Information

NPI Number : 1659661478
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON SCOTT WARD M.D.
Provider Business Mailing Address
First Line : 6401 FRANCE AVE S
Second Line : FAIRVIEW SOUTHDALE HOSPITAL
City : EDINA
State : MN
Zip : 55435-2199
Country : US
Telephone Number : 952-924-8463
Fax Number : 952-924-8358
Provider Business Practice Location Address
First Line : 6401 FRANCE AVE S
Second Line : FAIRVIEW SOUTHDALE HOSPITAL
City : EDINA
State : MN
Zip : 55435-2199
Country : US
Telephone Number : 952-924-8463
Fax Number : 952-924-8358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2011
Last Update Date : 12/29/2016

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