Provider Demographics
NPI:1073552121
Name:BATES, WILLIAM THURMAN III (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THURMAN
Last Name:BATES
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6401 MOUNTAIN VIEW ROAD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363
Mailing Address - Country:US
Mailing Address - Phone:423-495-5951
Mailing Address - Fax:423-495-5999
Practice Address - Street 1:6401 MOUNTAIN VIEW ROAD
Practice Address - Street 2:SUITE 109
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-495-5951
Practice Address - Fax:423-495-5999
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO0000001536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514172Medicaid
TN103I083569Medicare PIN
TNH95269Medicare UPIN