Individual
WARD B. WALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 PABLO ST, LAKELAND, FL 33803-3818
(863) 687-1259
(863) 284-1786
Mailing address
1324 LAKELAND HILLS BLVD, ATTN MEDICAL STAFF OFFICE, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME90509
FL
Other
Enumeration date
09/20/2005
Last updated
07/28/2022
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