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General NPI Number Information
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NPI Number | 1477658847
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Entity Type | Organization
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Legal Business Name | PHILIP D BATES, MD, INC.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 1735 27TH ST BUILDING C SUITE 103
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2677
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Country | US
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Telephone | 740-353-3200
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Fax | 740-353-3220
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Provider Business Mailing Address
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Address Line | PO BOX 2009
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City | PORTSMOUTH
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State | OH
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Zip | 45662-7909
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Country | US
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Telephone | 740-353-3200
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Fax | 740-353-3220
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP D BATES
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Credential | MD
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Telephone | 740-353-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35075658
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License Number State | OH
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