Provider Demographics
NPI:1316974421
Name:WARD, ALBERT A III (PA)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:A
Last Name:WARD
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:170 GALESBURG DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4860
Mailing Address - Country:US
Mailing Address - Phone:770-806-1612
Mailing Address - Fax:
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:2C 116
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA001170363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical