Ward, Tiffany
Ward, Tiffany is an individual health care provider with primary practice located at 305 W Jackson St Ste 103 , Carbondale IL 62901-1474. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Ward, Tiffany can be contacted via phone (618) 351-4972.Contact Information
Primary practice address
305 W Jackson St Ste 103
Carbondale IL 62901-1474
Phone: (618) 351-4972
Fax: (618) 351-6522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036141201 | Illinois |
Profile Details
| NPI number | 1619186269 |
|---|---|
| LBN Legal business name | Ward, Tiffany |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 21st, 2007 |
| Last updated | Nov 3rd, 2022 - about 2 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619186269 | NPPES |
| Illinois | Other | 214881 | GROUP MEDICARE PTAN |
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