Individual
DR. JEFFERY EUGENE GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
552 EMILY DR, CLARKSBURG, WV 26301-5508
(304) 623-2892
(304) 622-2809
Mailing address
5 OAK LN, BRIDGEPORT, WV 26330-1385
(304) 842-6525
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WV-903OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149812000
—
WV
05
—
0149812001
—
WV
Enumeration date
04/12/2007
Last updated
07/09/2007
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