Provider Demographics
NPI:1144322082
Name:WARD, RICHARD K (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 N 195TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5173
Mailing Address - Country:US
Mailing Address - Phone:402-763-9186
Mailing Address - Fax:
Practice Address - Street 1:810 N. 22ND STREET
Practice Address - Street 2:MCH & HEALTH SYSTEM
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008
Practice Address - Country:US
Practice Address - Phone:402-426-2182
Practice Address - Fax:402-426-1297
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16675207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39-01342OtherUHC
NE470780857 15Medicaid
KS200353570AMedicaid
IA0586024Medicaid
SD7716420Medicaid
NE00943OtherBCBS
NE00943OtherBCBS
NE39-01342OtherUHC
D05164Medicare UPIN
SD7716420Medicaid
NE470780857 15Medicaid