Provider Demographics
NPI:1912952391
Name:GAAR, EDWIN EARL (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:EARL
Last Name:GAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11102 OWL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2439
Mailing Address - Country:US
Mailing Address - Phone:502-244-5775
Mailing Address - Fax:502-287-6825
Practice Address - Street 1:800 ZORN AVENUE (112)
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-287-6804
Practice Address - Fax:502-287-6825
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23387174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC73712Medicare UPIN