Provider Demographics
NPI:1730273707
Name:BLANE E. BATEMAN, DO
Entity type:Organization
Organization Name:BLANE E. BATEMAN, DO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLANE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BATEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-238-0200
Mailing Address - Street 1:901 LEIGHTON AVE
Mailing Address - Street 2:STE 506
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5721
Mailing Address - Country:US
Mailing Address - Phone:256-238-0200
Mailing Address - Fax:256-236-8007
Practice Address - Street 1:901 LEIGHTON AVE
Practice Address - Street 2:STE 506
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5721
Practice Address - Country:US
Practice Address - Phone:256-238-0200
Practice Address - Fax:256-236-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF08624Medicare UPIN