Mallory Bates

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Cuthbert, GA

NPI 1306173471 · NPPES record last updated Nov 11, 2009

Key facts

NPI
1306173471
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
3665 Cotton Hill Rd
Cuthbert, GA 39840-4919
Phone
(229) 881-4764
NPI assigned
Nov 11, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

3665 Cotton Hill Rd
Cuthbert, GA 39840-4919

Mailing address

3665 Cotton Hill Rd
Cuthbert, GA 39840-4919
Phone (229) 881-4764

Other providers in Cuthbert, GA

All providers in Cuthbert, GA · Student in an Organized Health Care Education/Training Program in Georgia

Sources for this page

Verify at the official NPI Registry.