Provider Demographics
NPI:1720277619
Name:WARD, DAVID C (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:WARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6111
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41022-6111
Mailing Address - Country:US
Mailing Address - Phone:859-628-8843
Mailing Address - Fax:
Practice Address - Street 1:800 KEMPER COMMONS CIR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-2544
Practice Address - Country:US
Practice Address - Phone:859-628-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH4899152W00000X
KYKY1633DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist