Basic Information
| Provider Information | |||||||||
| NPI: | 1487944724 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WARD | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD/PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 W CHARLESTON BLVD STE 490 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712273 | ||||||||
| FaxNumber: | 7023859399 | ||||||||
| Practice Location | |||||||||
| Address1: | 1707 W CHARLESTON BLVD STE 160 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026715150 | ||||||||
| FaxNumber: | 7023846493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2011 | ||||||||
| LastUpdateDate: | 08/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | 20087 | NV | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.