Basic Information
| Provider Information | |||||||||
| NPI: | 1063651404 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | H. OWEN WARD, PH.D. INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2205 N LIMESTONE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 455032675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373907773 | ||||||||
| FaxNumber: | 9373908765 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 N LIMESTONE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 455032675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373907773 | ||||||||
| FaxNumber: | 9373908765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2009 | ||||||||
| LastUpdateDate: | 03/10/2009 | ||||||||
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| AuthorizedOfficialLastName: | WARD | ||||||||
| AuthorizedOfficialFirstName: | H | ||||||||
| AuthorizedOfficialMiddleName: | OWEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9373907773 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 4444 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.