Provider Demographics
NPI:1659363513
Name:GEAR, ROBERT LEE III (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:GEAR
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5204
Mailing Address - Country:US
Mailing Address - Phone:602-263-8484
Mailing Address - Fax:602-263-3697
Practice Address - Street 1:3543 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5204
Practice Address - Country:US
Practice Address - Phone:602-263-8484
Practice Address - Fax:602-263-3697
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3202207QS0010X, 207P00000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG74456Medicare UPIN