Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 11827 | TN |
NPI | 1306804422 |
---|---|
Provider Name | Dr. Jewell C Ward |
First Address | Memphis, TN 38105 |
Second Address | Memphis, TN 38105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 27/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3177268 | (05) | TN |
B03759 | (02) |