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General NPI Number Information
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NPI Number | 1225332026
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Entity Type | Organization
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Legal Business Name | DAVID M. BATES, DPM, PLLC
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 15182 N 75TH AVE SUITE 180
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City | PEORIA
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State | AZ
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Zip | 85381-4722
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Country | US
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Telephone | 623-243-5737
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Fax | 623-399-4091
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Provider Business Mailing Address
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Address Line | 15182 N 75TH AVE SUITE 180
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City | PEORIA
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State | AZ
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Zip | 85381-4722
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Country | US
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Telephone | 623-243-5737
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Fax | 623-399-4091
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID M BATES
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Credential | DPM
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Telephone | 623-243-5737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0592
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License Number State | AZ
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