Provider Demographics
NPI:1922007509
Name:CATES, MARK DENNIS (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DENNIS
Last Name:CATES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 TOWNSHIP ROAD 1153
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9746
Mailing Address - Country:US
Mailing Address - Phone:419-289-0031
Mailing Address - Fax:419-289-1473
Practice Address - Street 1:1508 TOWNSHIP ROAD 1153
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-9746
Practice Address - Country:US
Practice Address - Phone:419-289-0031
Practice Address - Fax:419-289-1473
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4400245OtherUNITED HEALTHCARE
OH0637921Medicaid
OH000000135014OtherANTHEM BLUE CROSS/BLUE SH
OH4400245OtherUNITED HEALTHCARE