MEDICARE: DR. GERALD T WARE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	E1338	AR

General Provider Information

NPI Number	:	1851373484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD T WARE M.D.

Provider Business Mailing Address
First Line	:	#3 KYLE COURT
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800 BAPTIST HEALTH DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6243
Country	:	US
Telephone Number	:	501-219-0900
Fax Number	:	501-312-4750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	04/08/2019

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