Provider Demographics
NPI:1710398441
Name:COMPLETE MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:COMPLETE MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLBON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-438-1221
Mailing Address - Street 1:120 RIDGECREST RD
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-6422
Mailing Address - Country:US
Mailing Address - Phone:256-438-1221
Mailing Address - Fax:256-442-8068
Practice Address - Street 1:120 RIDGECREST RD
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-6422
Practice Address - Country:US
Practice Address - Phone:256-438-1221
Practice Address - Fax:256-442-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE3646Medicare UPIN