Individual
JACKSON P WARD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
750 TOWNPARK LN NW, TOWN PARK COMPREHENSIVE MEDICAL CENTER, KENNESAW, GA 30144-5579
(770) 514-5401
(770) 994-4747
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678
(770) 994-4747
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
03220
GA
Other
Enumeration date
11/22/2006
Last updated
01/07/2022
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