MEDICARE: KIMBERLY BATES MD

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
1	207R00000X	Internal Medicine Physician	21628	NV
2	207R00000X	Internal Medicine Physician	MD491493C	PA
3	208000000X	Pediatrics Physician	21628	NV
4	208M00000X	Hospitalist Physician	21628	NV
5	208000000X	Pediatrics Physician	MD491493C	PA

General Provider Information

NPI Number	:	1730166091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BATES MD

Provider Business Mailing Address
First Line	:	PO BOX 33269
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85067-3269
Country	:	US
Telephone Number	:	602-406-4786
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 W CRAIG RD STE 220
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0329
Country	:	US
Telephone Number	:	702-616-5801
Fax Number	:	702-399-8431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	09/07/2025

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Directions to “ KIMBERLY BATES MD” Practice Location

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