Provider Demographics
NPI:1790829463
Name:OATES, DAVID R (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:OATES
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:460 MALL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4801
Mailing Address - Country:US
Mailing Address - Phone:912-644-5300
Mailing Address - Fax:912-644-5260
Practice Address - Street 1:3301 E 1ST ST
Practice Address - Street 2:SUITE B
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8674
Practice Address - Country:US
Practice Address - Phone:912-537-0888
Practice Address - Fax:912-644-5260
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2016-03-22
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Provider Licenses
StateLicense IDTaxonomies
GA3508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ07476Medicare UPIN