MEDICARE: TY L. BATTERSHELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	6504A	WY

General Provider Information

NPI Number	:	1518987379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TY L. BATTERSHELL M.D.

Provider Business Mailing Address
First Line	:	201 14TH ST
Second Line	:	EMERGENCY DEPARTMENT
City	:	WHEATLAND
State	:	WY
Zip	:	82201-3201
Country	:	US
Telephone Number	:	307-322-3636
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 14TH ST
Second Line	:	EMERGENCY DEPARTMENT
City	:	WHEATLAND
State	:	WY
Zip	:	82201-3201
Country	:	US
Telephone Number	:	307-322-3636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/07/2008

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