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General NPI Number Information
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NPI Number | 1770930091
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Entity Type | Organization
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Legal Business Name | RONALD J BATES D.O., P.A.
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 409 VIRGINIA DR
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City | BATESVILLE
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State | AR
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Zip | 72501-7329
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Country | US
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Telephone | 870-793-3400
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Fax | 870-793-7737
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Provider Business Mailing Address
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Address Line | 409 VIRGINIA DR
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City | BATESVILLE
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State | AR
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Zip | 72501-7329
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Country | US
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Telephone | 870-793-3400
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Fax | 870-793-7737
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Authorized Official
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Title or Position | CLAIMS MANAGER
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Name | MS. AUNDRIA TAYLOR
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Credential |
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Telephone | 870-793-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N-8409
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License Number State | AR
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