Individual
TYE WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1500 E DOWNING ST, SUITE 214, TAHLEQUAH, OK 74464-3234
(918) 431-0202
(918) 432-0203
Mailing address
PO BOX 751, HULBERT, OK 74441-0751
(918) 772-3390
(918) 432-0203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4140
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018970A
—
OK
Enumeration date
07/05/2006
Last updated
06/04/2019
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