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Organization
SAMUEL E WARD MD PL
Active
Organization
SAMUEL E WARD MD PL
Active
Other names
Ward Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JEAN HAWKINS (OFFICE MANAGER)
(850) 547-3679
Entity
Organization
Contact information
Practice address
3607 ROCHE AVE, VERNON, FL 32462-3358
(850) 547-3679
(855) 492-6785
Mailing address
3803 GALILEE RD, GRACEVILLE, FL 32440-4721
(850) 547-3679
(855) 492-6785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266048200
—
FL
01
—
35511
BLUE SHIELD
—
Enumeration date
01/05/2006
Last updated
09/11/2023
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