Healthcare Provider Details

I. General information

NPI: 1730273707
Provider Name (Legal Business Name): BLANE E. BATEMAN, DO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LEIGHTON AVE STE 506
ANNISTON AL
36207-5721
US

IV. Provider business mailing address

901 LEIGHTON AVE STE 506
ANNISTON AL
36207-5721
US

V. Phone/Fax

Practice location:
  • Phone: 256-238-0200
  • Fax: 256-236-8007
Mailing address:
  • Phone: 256-238-0200
  • Fax: 256-236-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: BLANE EDWARD BATEMAN
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 256-238-0200