Individual
OLLICE BATES JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11 9TH ST, SELINSGROVE, PA 17870-8409
(570) 374-7799
(570) 374-3469
Mailing address
309 JADE AVE, DANVILLE, PA 17821-8537
(570) 275-7698
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD013557E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0689716
—
PA
Enumeration date
02/27/2006
Last updated
07/08/2007
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