Provider Demographics
NPI:1023158334
Name:WARE, JAMES PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:WARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:PATRICK
Other - Last Name:WARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 871149
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0029
Mailing Address - Country:US
Mailing Address - Phone:770-806-8323
Mailing Address - Fax:
Practice Address - Street 1:6340 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4333
Practice Address - Country:US
Practice Address - Phone:770-806-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0156952084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD46842Medicare UPIN
GA26BDDWMMedicare ID - Type Unspecified