Healthcare Provider Details

I. General information

NPI: 1326224122
Provider Name (Legal Business Name): DAVID B. WARE, M.D., A.P.M.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 MOOSA BLVD
EUNICE LA
70535-3638
US

IV. Provider business mailing address

281 MOOSA BLVD
EUNICE LA
70535-3638
US

V. Phone/Fax

Practice location:
  • Phone: 337-457-2200
  • Fax: 337-457-2203
Mailing address:
  • Phone: 337-457-2200
  • Fax: 337-457-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number14666R
License Number StateLA

VIII. Authorized Official

Name: DR. DAVID BENJAMIN WARE
Title or Position: OWNER
Credential: M.D.
Phone: 337-457-2200