Ware, Paul Derek

Ware, Paul Derek is an individual health care provider with primary practice located at 1340 Broad Ave Suite 240, Gulfport MS 39501-2404. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Ware, Paul Derek can be contacted via phone (228) 575-1200.

Contact Information

Primary practice address
1340 Broad Ave Suite 240 Gulfport MS 39501-2404
Phone: (228) 575-1200
Fax: (228) 575-1205
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 025475 Louisiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 025475 Louisiana

Profile Details

NPI number 1053374041
LBN Legal business name Ware, Paul Derek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 11th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053374041 NPPES
Louisiana MEDICAID 1579009

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