Provider Demographics
NPI:1174742688
Name:WARD, E FRAZIER (MD)
Entity type:Individual
Prefix:DR
First Name:E
Middle Name:FRAZIER
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 1:2500 NORTH STATE STREET
Mailing Address - Street 2:ORTHOPAEDIC SURGERY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-984-6525
Mailing Address - Fax:601-984-5151
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:ORTHOPAEDIC SURGERY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-984-6525
Practice Address - Fax:601-984-5151
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05169207XP3100X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00013744Medicaid
MS0013744Medicaid
MS207X00000XOtherTAXONOMY
51220014OtherMCR PTAN
MS302I205884Medicare PIN
MS207X00000XOtherTAXONOMY
200000138Medicare PIN
MS200000138Medicare ID - Type Unspecified
B31132Medicare UPIN