| Bates Family Practice Pllc | |
|
520 E Bethany Home Rd Phoenix AZ 85012-1207 | |
| (602) 726-3301 | |
| (602) 654-3300 |
| Full Name | Bates Family Practice Pllc |
|---|---|
| Speciality | General Practice |
| Location | 520 E Bethany Home Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Gina Bates (OWNER) |
| Authorized Official Contact | 5125544523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bates Family Practice Pllc 520 E Bethany Home Rd Phoenix AZ 85012-1207 Ph: (602) 726-3301 | Bates Family Practice Pllc 520 E Bethany Home Rd Phoenix AZ 85012-1207 Ph: (602) 726-3301 |
| NPI Number | 1336734946 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 11/21/2023 |
| Medicare PECOS PAC ID | 4284043530 |
|---|---|
| Medicare Enrollment ID | O20210517002574 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336734946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Gina Suzanne Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063524791 PECOS PAC ID: 9436257201 Enrollment ID: I20150807015686 |
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