Provider Demographics
NPI:1770184319
Name:BATES, NOBLE ELIAS (OWNER)
Entity Type:Individual
Prefix:MR
First Name:NOBLE
Middle Name:ELIAS
Last Name:BATES
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 BATES ROAD
Mailing Address - Street 2:
Mailing Address - City:FRIERSON
Mailing Address - State:LA
Mailing Address - Zip Code:71027-2016
Mailing Address - Country:US
Mailing Address - Phone:318-584-9803
Mailing Address - Fax:318-872-2088
Practice Address - Street 1:639ABATE ROAD
Practice Address - Street 2:
Practice Address - City:FRIERSON
Practice Address - State:LA
Practice Address - Zip Code:71027-2016
Practice Address - Country:US
Practice Address - Phone:318-584-9803
Practice Address - Fax:318-872-2088
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health