MEDICARE: ROBERT LEE GEAR III D.O.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	3202	AZ
2	207P00000X	Emergency Medicine Physician	3202	AZ
3	2083A0100X	Aerospace Medicine Physician	3202	AZ

General Provider Information

NPI Number	:	1659363513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LEE GEAR III D.O.

Provider Business Mailing Address
First Line	:	3543 N 7TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-5204
Country	:	US
Telephone Number	:	602-263-8484
Fax Number	:	602-263-3697

Provider Business Practice Location Address
First Line	:	3543 N 7TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-5204
Country	:	US
Telephone Number	:	602-263-8484
Fax Number	:	602-263-3697

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/29/2007

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