Individual
KENNETH ROBERT BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 11TH ST SE, BANDON, OR 97411-9114
(541) 347-2426
Mailing address
900 11TH ST SE, BANDON, OR 97411-9114
(541) 347-2426
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD19858
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082941
—
OR
Enumeration date
08/08/2006
Last updated
07/08/2007
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