Healthcare Provider Details

I. General information

NPI: 1023158334
Provider Name (Legal Business Name): JAMES PATRICK WARE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J PATRICK WARE MD

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 SUGARLOAF PKWY SUITE 200
DULUTH GA
30097-4333
US

IV. Provider business mailing address

PO BOX 871149
STONE MOUNTAIN GA
30087-0029
US

V. Phone/Fax

Practice location:
  • Phone: 770-806-8323
  • Fax:
Mailing address:
  • Phone: 770-806-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number015695
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: