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Individual

DR. JONATHAN JAMES BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10000 ZANE AVE N, BROOKLYN PARK, MN 55443-1400
(763) 572-5710
(763) 569-6200
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 572-5710
(763) 571-3008

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41568
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0104111
MEDICA
MN
01
1020259
PREFERRED ONE
MN
01
123620
UCARE MN
MN
05
546316500
MN
01
6603833
MEDICA UC NUMBER
MN
01
68D53BA
BCBS OF MN
MN
01
7711010
AETNA
MN
01
850757
AMERICA'S PPO
MN
01
HP28999
HEALTHPARTNERS
MN
Enumeration date
04/05/2006
Last updated
05/03/2012
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