Provider Demographics
NPI:1770930091
Name:RONALD J BATES D.O., P.A.
Entity type:Organization
Organization Name:RONALD J BATES D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIMS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUNDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-793-3400
Mailing Address - Street 1:409 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7329
Mailing Address - Country:US
Mailing Address - Phone:870-793-3400
Mailing Address - Fax:870-793-7737
Practice Address - Street 1:409 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7329
Practice Address - Country:US
Practice Address - Phone:870-793-3400
Practice Address - Fax:870-793-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-8409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty