Individual
TIFFANY JO WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 COUNTRY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-2510
(719) 657-4106
Mailing address
310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-2510
(719) 657-4106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54014
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07186363
—
CO
01
—
364270YNJJ
MEDICAREE PTAN
CO
01
—
54014
LICENSE
CO
Enumeration date
06/21/2010
Last updated
01/14/2016
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