Provider Demographics
NPI:1851373484
Name:WARE, GERALD T (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:T
Last Name:WARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:#3 KYLE COURT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9800 BAPTIST HEALTH DR STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6243
Practice Address - Country:US
Practice Address - Phone:501-219-0900
Practice Address - Fax:501-312-4750
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1338207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5L303Medicare ID - Type Unspecified
ARG93180Medicare UPIN