Provider Demographics
NPI:1073692562
Name:BATES, KEVIN R (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:R
Last Name:BATES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S CHERRY ST
Mailing Address - Street 2:STE. 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2699
Mailing Address - Country:US
Mailing Address - Phone:720-941-5000
Mailing Address - Fax:303-394-2587
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:STE. 210
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2699
Practice Address - Country:US
Practice Address - Phone:720-941-5000
Practice Address - Fax:303-394-2587
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U95061Medicare UPIN
496048Medicare ID - Type Unspecified