Healthcare Provider Details

I. General information

NPI: 1184603052
Provider Name (Legal Business Name): JAMES L GATES M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 HOSPITAL PLZ
WESTON WV
26452-8558
US

IV. Provider business mailing address

3311 PRESCOTT RD SUITE 410
ALEXANDRIA LA
71301-3900
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-8000
  • Fax:
Mailing address:
  • Phone: 318-443-7222
  • Fax: 318-443-7641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number016830
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: