Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | PGY | LA |
Y | 2080A0000X | Adolescent Medicine | 310019 | LA |
NPI | 1164787321 |
---|---|
Provider Name | Reuben Oneal Battley |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 11/01/2021 |