MEDICARE: DR. MANDY LYNNE WARD O.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
1	152W00000X	Optometrist	5712	OH

General Provider Information

NPI Number	:	1871775825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANDY LYNNE WARD O.D.

Provider Business Mailing Address
First Line	:	8135 MARKET ST
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-6244
Country	:	US
Telephone Number	:	330-758-0900
Fax Number	:	330-758-2790

Provider Business Practice Location Address
First Line	:	2955 E STATE ST STE 9
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-9307
Country	:	US
Telephone Number	:	330-758-8183
Fax Number	:	330-758-8849

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

Provider Enumeration Date	:	12/01/2007
Last Update Date	:	04/10/2026

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