Individual
DR. GRACE LUCTA WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 W STONE DR, KINGSPORT, TN 37660
(423) 392-6265
Mailing address
105 W STONE DR STE 4A, KINGSPORT, TN 37660-3365
(423) 392-6265
(423) 392-6272
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
57975
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2013
Last updated
02/18/2019
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