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NPI 1003965492

NPI 1003965492 : KENNETH ALAN BATKO MD : SUN CITY, AZ

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General NPI Number Information
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    NPI Number           |    1003965492
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH ALAN BATKO MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/09/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    10615 W THUNDERBIRD BLVD B300
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    City                 |    SUN CITY
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    State                |    AZ
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    Zip                  |    85351-3059
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    Country              |    US
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    Telephone            |    623-933-0176
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    Fax                  |    623-933-2808
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Provider Business Mailing Address
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    Address Line         |    10615 W THUNDERBIRD BLVD B300
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    City                 |    SUN CITY
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    State                |    AZ
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    Zip                  |    85351
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    Country              |    US
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    Telephone            |    623-933-0176
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    Fax                  |    623-933-2808
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207W00000X
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    Taxonomy Name        |    Ophthalmology Physician
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    License Number       |    11931
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    License Number State |    AZ
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