Individual
DR. MARK R WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 E KEARNEY ST, SPRINGFIELD, MO 65803-4106
(417) 863-9190
(417) 863-9073
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R1B19
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10104
MO BLUE SHIELD
MO
05
—
201633765
—
MO
01
—
99242
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/06/2013
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