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Individual

KEVIN WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
6095 PROFESSIONAL PKWY STE A210, DOUGLASVILLE, GA 30134
(770) 949-4188
(770) 949-1614
Mailing address
6095 PROFESSIONAL PKWY STE A210, DOUGLASVILLE, GA 30134-5611
(770) 949-4188
(770) 949-1614

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
125060900
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
77984
GA

Other

Enumeration date
09/17/2012
Last updated
09/26/2019
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