Provider Demographics
NPI:1508940537
Name:BATES, KEVIN R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:R
Last Name:BATES
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2405 N COLUMBUS ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8185
Mailing Address - Country:US
Mailing Address - Phone:740-687-3346
Mailing Address - Fax:740-689-9736
Practice Address - Street 1:2405 N COLUMBUS ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8185
Practice Address - Country:US
Practice Address - Phone:740-687-3346
Practice Address - Fax:740-689-9736
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant