Individual
DUSTIN L BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
11408 KINGSTON PIKE STE 400, KNOXVILLE, TN 37934-3976
(865) 392-1888
(865) 392-1889
Mailing address
11408 KINGSTON PIKE STE 400, KNOXVILLE, TN 37934-3976
(865) 392-1888
(865) 392-1889
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000003166
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I976498
MEDICARE PTAN
TN
01
—
P01878527
RRMEDICARE PTAN
TN
05
—
Q029343
—
TN
Enumeration date
11/15/2010
Last updated
07/21/2022
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