Provider Demographics
NPI:1073675096
Name:BATES, WILLIAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:BATES
Suffix:
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 1:1000 URLIN AVE
Mailing Address - Street 2:SUITE #2006
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3362
Mailing Address - Country:US
Mailing Address - Phone:614-487-1812
Mailing Address - Fax:
Practice Address - Street 1:1000 URLIN AVE
Practice Address - Street 2:SUITE #2006
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3362
Practice Address - Country:US
Practice Address - Phone:614-487-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0379762084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities