Individual
MR. DEVAN ALLEN WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3920 DUTCHMANS LN STE 310, LOUISVILLE, KY 40207-4702
(502) 588-0328
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2339
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004522800
—
FL
05
—
7100506390
—
KY
Enumeration date
11/08/2011
Last updated
08/29/2024
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