Provider Demographics
NPI:1730370800
Name:WARD, JESSICA ANN (DO)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:WARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:4830 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5207
Practice Address - Country:US
Practice Address - Phone:717-657-2595
Practice Address - Fax:717-657-3091
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2015-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021703250001Medicaid
PA1021703250001Medicaid
MD970251OtherCAREFIRST MD BCBS-WMG
PA1583131OtherGATEWAY-WMG
PAP01417496Medicare PIN
MD036078300Medicaid
PA50079252OtherCAPITAL BLUE CROSS
PA102170325Medicaid
PA192945FLTMedicare PIN
PA128147FLTMedicare PIN
PA1853169OtherAETNA
PA2053074OtherHIGHMARK BLUE SHIELD-WMG
PA1021703250001Medicaid
PA30083829OtherAMERIHEALTH MERCY-WMG