Kenneth Robert Bates, MD
Individual provider Active NPI Hospitalist Physician · Bandon, OR
NPI 1891705299 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891705299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- MD19858 (OR)
- Practice address
- 900 11TH St SE
Bandon, OR 97411-9114 - Phone
- (541) 347-2426
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19858 | OR | MD | Hospitalist Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | MD19858 | OR | Yes |
Addresses
Primary practice location
900 11TH St SE
Bandon, OR 97411-9114
Mailing address
900 11TH St SE
Bandon, OR 97411-9114
Phone (541) 347-2426
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082941 | Medicaid | OR |
Other providers in Bandon, OR
- Bandon Community Health Center
- Bandon Family Medicine, LLC
- Bandon Pharmacy
- Bandon Senior Living LLC
- Janet M Bates
- Rosemary Winifred Bean
- Blue Diamond Estates
- Linda M Bono
- Christina Marie Brakebill
- Stephen Hutchins Brown
All providers in Bandon, OR · Hospitalist Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.