Provider Demographics
NPI:1174727770
Name:WARD, KRISTY KAY (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:KAY
Last Name:WARD
Suffix:
Gender:F
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4500
Practice Address - Fax:304-598-4560
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0022205207V00000X
TXN4834207V00000X, 207VX0201X
FLME120258207VX0201X
WV31061207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2766284732OtherMYUTMB 2766284732-COMMERCIAL NUMBER
TX366203302Medicaid
TX366203301Medicaid
TX366203302Medicaid
TX546652YKYCMedicare PIN