Provider Demographics
NPI:1720347941
Name:BATES, HANNAH EASON (MD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:EASON
Last Name:BATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WATERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7847
Mailing Address - Country:US
Mailing Address - Phone:256-517-3011
Mailing Address - Fax:
Practice Address - Street 1:107 WATERFORD CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7847
Practice Address - Country:US
Practice Address - Phone:256-517-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123521207P00000X
AL37210207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIE213ZMedicare PIN