| Samuel E Ward Md Pl | |
|
3607 Roche Ave Vernon FL 32462-3358 | |
| (850) 547-3679 | |
| (855) 492-6785 |
| Full Name | Samuel E Ward Md Pl |
|---|---|
| Speciality | Family Medicine |
| Location | 3607 Roche Ave, Vernon, Florida |
| Authorized Official Name and Position | Jessica Jean Hawkins (OFFICE MANAGER) |
| Authorized Official Contact | 8505473679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel E Ward Md Pl 3803 Galilee Rd Graceville FL 32440-4721 Ph: (850) 547-3679 | Samuel E Ward Md Pl 3607 Roche Ave Vernon FL 32462-3358 Ph: (850) 547-3679 |
| NPI Number | 1255319695 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 09/11/2023 |
| Medicare PECOS PAC ID | 8022056415 |
|---|---|
| Medicare Enrollment ID | O20050418000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255319695 | NPI | - | NPPES |
| 35511 | Other | BLUE SHIELD | |
| 266048200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Samuel Edward Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982661757 PECOS PAC ID: 2062401169 Enrollment ID: I20050419000256 |
Northwest Florida Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3250 Main St, Vernon, FL 32462 Phone: 850-535-2096 | |
Northwest Florida Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3250 Main St, Vernon, FL 32462 Phone: 850-535-2096 |