Provider Demographics
NPI:1073612503
Name:BATES, HARRY CLARK III (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:CLARK
Last Name:BATES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 RICHMOND ROAD
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-4000
Mailing Address - Country:US
Mailing Address - Phone:540-332-2113
Mailing Address - Fax:540-332-2202
Practice Address - Street 1:1355 RICHMOND ROAD
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24402-4000
Practice Address - Country:US
Practice Address - Phone:540-332-2113
Practice Address - Fax:540-332-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010337152084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry