Doctor Name: | DR. PHILLIP DALE BATES |
NPI Number: | 1033479233 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 17298 |
Business Practice Address: | 1600 Sw Archer Rd Department Of Radiology Gainesville, FL - 326100374 |
Business Phone Number: | 3522650291 |
Business Fax Number: | 3522650279 |
Mailing Address: | 8520 Sw 66th Ln, GAINESVILLE |
State: | FL |
Postal Code: | 326085655 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/21/2012 |
NPI Last Update Date: | 07/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 17298 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |