Kelly P Ward PA

NPI 1073595104 - Physician Assistant - 363AM0700X

NPI Details
NPI 1073595104
Gender Male
Enumeration Date 11/15/2005
Last Updated 05/20/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
1765 OLD WEST BROAD ST
BLDG 2, STE 200
ATHENS GA, 30606-2853, US
Phone (706) 549-1663
Fax (706) 546-8792
Business Location
1765 OLD WEST BROAD ST
BLDG 2, STE 200
ATHENS GA, 30606-2853, US
Phone (706) 549-1663
Fax (706) 546-8792
Toxanomy
Taxonomy Code 363AM0700X
License State Georgia
License Number 003050
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According to our database, Kelly P Ward PA NPI is 1073595104, taxonomy code is 363AM0700X and license number is 003050, license state is located at Georgia. Kelly P Ward PA physically located at 1765 Old West Broad St, Athens GA, 30606-2853. NPI Number Kelly P Ward PA has the Individual type.

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1073595104 NPI number is provided on an as is basis without warranty of any kind. 1073595104 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly P Ward PA are for informational purposes only.