Basic Information
| Provider Information | |||||||||
| NPI: | 1336257369 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KENNETH W GERARD MD PHD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 AQUAMARINE DR | ||||||||
| Address2: | |||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330405601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024630366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5900 COLLEGE RD | ||||||||
| Address2: | LOWER KEYS MEDICAL CENTER ANESTHESIA DEPT | ||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052945531 | ||||||||
| FaxNumber: | 3052929196 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 09/04/2007 | ||||||||
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| AuthorizedOfficialLastName: | GERARD | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3024630366 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD, PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME96504 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.