Provider Demographics
NPI:1497849491
Name:GATES, WILLIAM GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GENE
Last Name:GATES
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 1:5410 OLD HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-883-2356
Mailing Address - Fax:615-872-0863
Practice Address - Street 1:5410 OLD HICKORY RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-883-2356
Practice Address - Fax:615-872-0863
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24319207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F54823Medicare UPIN
TN3074933Medicare ID - Type Unspecified