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NPI Code Detail

MEDICARE: BATES FAMILY MEDICINE, PLLC

MEDICARE: BATES FAMILY MEDICINE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1629354287
Entity Type Code : Organization
Provider Name (Legal Business Name) : BATES FAMILY MEDICINE, PLLC
Provider Business Mailing Address
First Line : 2401 N OCOEE ST
Second Line : SUITE 102
City : CLEVELAND
State : TN
Zip : 37311-3853
Country : US
Telephone Number : 423-472-4677
Fax Number : 423-472-4620
Provider Business Practice Location Address
First Line : 2401 N OCOEE ST
Second Line : SUITE 102
City : CLEVELAND
State : TN
Zip : 37311-3853
Country : US
Telephone Number : 423-472-4677
Fax Number : 423-472-4620
Authorized Official
Title or Position : DO/OWNER
Name : WILLIAM T BATES III
Credential : DO
Telephone Number : 423-472-4677
Provider Enumeration Date : 10/27/2011
Last Update Date : 06/02/2014

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