Provider Demographics
NPI:1760431050
Name:GERALD, ANN K (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:K
Last Name:GERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6565 E CARONDELET DR STE 145
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-3545
Mailing Address - Country:US
Mailing Address - Phone:520-886-4199
Mailing Address - Fax:520-886-3114
Practice Address - Street 1:6565 E CARONDELET DR STE 145
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3545
Practice Address - Country:US
Practice Address - Phone:520-886-4199
Practice Address - Fax:520-886-3114
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2017-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ43734207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78718Medicare ID - Type Unspecified