Organization
NORTHRIDGE INTERNAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY BATES D.O. (MEMBER)
(208) 656-8456
Entity
Organization
Contact information
Practice address
36 PROFESSIONAL PLZ, STE-102, REXBURG, ID 83440-2049
(208) 656-8456
(208) 656-8444
Mailing address
36 PROFESSIONAL PLZ, STE-102, REXBURG, ID 83440-2049
(208) 656-8456
(208) 656-8444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
O0359
ID
Other
Enumeration date
12/31/2007
Last updated
02/11/2008
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