Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 3187 | AZ |
NPI | 1003818246 |
---|---|
Provider Name | Dr. Kathryn L Bates |
First Address | Tucson, AZ 85712-4046 |
Second Address | Tucson, AZ 85710-6154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 20/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I04691 | (02) | AZ |