Provider Demographics
NPI:1306374616
Name:FORD, JOHN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:FORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 HAMILTON WAY
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-6704
Mailing Address - Country:US
Mailing Address - Phone:801-390-8463
Mailing Address - Fax:
Practice Address - Street 1:400 N JEFFERSON ST
Practice Address - Street 2:ROBERT C BYRD CLINIC
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:304-645-3220
Practice Address - Fax:304-647-1273
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVED0717207P00000X, 207Q00000X
IN02006420A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine