Individual
MR. THOMAS FRANKLIN WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT-P
Contact information
Practice address
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
(850) 881-2337
Mailing address
215 SOUTHGATE DR, CRESTVIEW, FL 32539-6377
(850) 398-5557
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1003X
TRICARE
—
Enumeration date
04/19/2009
Last updated
01/24/2012
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