Provider Demographics
NPI:1730372830
Name:BATTALA, NAGA L (MD)
Entity type:Individual
Prefix:DR
First Name:NAGA
Middle Name:L
Last Name:BATTALA
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 1:3000 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4202
Mailing Address - Country:US
Mailing Address - Phone:307-362-1861
Mailing Address - Fax:307-362-1277
Practice Address - Street 1:3000 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4202
Practice Address - Country:US
Practice Address - Phone:307-362-1861
Practice Address - Fax:307-362-1277
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104785207V00000X, 174400000X
WY10119A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27-3952577OtherOM SAI OBGYN CLINIC TAX ID
CA00A1047850Medicaid
CAA1047850Medicare UPIN
CA00A1047850Medicaid