Provider Demographics
NPI:1962678912
Name:CATES, BARBARA ANNE
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:CATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 DAKOTA RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-8363
Mailing Address - Country:US
Mailing Address - Phone:870-448-5910
Mailing Address - Fax:
Practice Address - Street 1:280 DAKOTA RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650-8363
Practice Address - Country:US
Practice Address - Phone:870-448-5910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR166584778Medicaid