Healthcare Provider Details

I. General information

NPI: 1932382223
Provider Name (Legal Business Name): USS KITTY HAWK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USS KITTY HAWK CV 63 MEDICAL
FPO AP
96634-2770
JP

IV. Provider business mailing address

USS KITTY HAWK CV 63 MEDICAL
FPO AP
96634-2770
JP

V. Phone/Fax

Practice location:
  • Phone: 01181468166653
  • Fax:
Mailing address:
  • Phone: 01181468166653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAYMOND BATZ
Title or Position: SENIOR MEDICAL OFFICER
Credential:
Phone: 01181468166653