Provider Demographics
NPI:1467424176
Name:CATES, JOHN T (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:CATES
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 1:2001 CHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1200
Mailing Address - Country:US
Mailing Address - Phone:765-966-0583
Mailing Address - Fax:765-966-0960
Practice Address - Street 1:2001 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1200
Practice Address - Country:US
Practice Address - Phone:765-966-0583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN466220GMedicaid
U93905Medicare UPIN