Individual
DR. PAUL DEREK WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 BROAD AVE, SUITE 240, GULFPORT, MS 39501-2404
(228) 575-1200
(228) 575-1205
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1200
(228) 575-1205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
025475
LA
208600000X
Surgery Physician
Primary
025475
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1579009
—
LA
Enumeration date
04/10/2006
Last updated
07/11/2014
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