Provider Demographics
NPI:1730540048
Name:FORD, MARY BARTLETT (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BARTLETT
Last Name:FORD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:BROOKE ARMY MEDICAL CENTER
Mailing Address - Street 2:3551 ROGER BROOKE DR.
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-5554
Mailing Address - Fax:210-916-5900
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:INFECTIOUS DISEASE
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-6017
Practice Address - Fax:210-916-5900
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2023-08-23
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Provider Licenses
StateLicense IDTaxonomies
VA0101264113207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease