Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 22310 | SC |
NPI | 1346217585 |
---|---|
Provider Name | Dr. John P. Batson III |
First Address | Hardeeville, SC 29927-4450 |
Second Address | Hardeeville, SC 29927-4450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 24/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223109 | (05) | SC |
570521956 | EMPLOYER ID# (01) | SC |
I34299 | (02) | SC |