Individual
FORREST T. BATES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 CEAPE AVE, STE 13, OSHKOSH, WI 54901-5227
(920) 236-3251
(920) 236-3255
Mailing address
325 N COMMERCIAL ST, NEENAH, WI 54956-2665
(920) 722-1583
(920) 722-7454
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25197
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31789500
—
WI
Enumeration date
12/21/2005
Last updated
07/08/2007
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