Provider Demographics
NPI:1437135480
Name:BATES, DONALD CHRISTOPHER (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:CHRISTOPHER
Last Name:BATES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 NASHVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7116
Mailing Address - Country:US
Mailing Address - Phone:615-452-2992
Mailing Address - Fax:615-452-5935
Practice Address - Street 1:1112 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-7116
Practice Address - Country:US
Practice Address - Phone:615-452-2992
Practice Address - Fax:615-452-5935
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1705152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3940411Medicaid
TN3940411Medicare ID - Type Unspecified
TNV60867Medicare UPIN