Ward, Cody Lane

Ward, Cody Lane is an individual health care provider with primary practice located at 111 W Jefferson Blvd Ste 100 , South Bend IN 46601-1993. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Ward, Cody Lane can be contacted via phone (574) 647-1670.

Contact Information

Primary practice address
111 W Jefferson Blvd Ste 100 South Bend IN 46601-1993
Phone: (574) 647-1670
Fax: (574) 647-6927
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01088698A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 01088698A Indiana

Profile Details

NPI number 1316501257
LBN Legal business name Ward, Cody Lane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2019
Last updated Apr 4th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316501257 NPPES
Indiana MEDICAID 300026726

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