MEDICARE: JOHN WILLIAM BATICH 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	207V00000X	Obstetrics & Gynecology Physician	175660	NY
2	174400000X	Specialist	21794	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146416	OTHER		UNITED MINE WORKERS
2	845896	OTHER		FIRST HEALTH
3	21794	OTHER	WV	UPPER OHIO VALLEY HEALTH
4	264495	OTHER		CARELINK
5	175660	OTHER	NY	NYS LICENSE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	7626136	OTHER		AETNA
9	7200274	OTHER	WV	CIGNA

General Provider Information

NPI Number	:	1982699906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WILLIAM BATICH M.D.

Provider Business Mailing Address
First Line	:	50 LEROY ST
Second Line	:
City	:	POTSDAM
State	:	NY
Zip	:	13676-1799
Country	:	US
Telephone Number	:	315-265-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 E MAIN ST
Second Line	:
City	:	CANTON
State	:	NY
Zip	:	13617-1450
Country	:	US
Telephone Number	:	315-714-3170
Fax Number	:	315-714-3176

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	07/10/2024

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