Healthcare Provider Details

I. General information

NPI: 1508776493
Provider Name (Legal Business Name): MR. DAVID S BATTLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12412 BITTERSWEET COMMONS BLVD W UNIT 1014
GRANGER IN
46530-5251
US

IV. Provider business mailing address

12412 BITTERSWEET COMMONS BLVD W UNIT 1014
GRANGER IN
46530-5251
US

V. Phone/Fax

Practice location:
  • Phone: 574-888-3388
  • Fax:
Mailing address:
  • Phone: 574-888-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: