Basic Information
Provider Information
NPI: 1578580114
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARD
FirstName: IRVING
MiddleName: BENJAMIN
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8717 W 110TH ST
Address2: SUITE 600
City: OVERLAND PARK
State: KS
PostalCode: 662102144
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber: 9134282951
Practice Location
Address1: 2100 SE BLUE PKWY
Address2:  
City: LEES SUMMIT
State: MO
PostalCode: 640631007
CountryCode: US
TelephoneNumber: 8162825000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/17/2006
LastUpdateDate: 03/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2003015186MOY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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