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General NPI Number Information
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NPI Number | 1700850658
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Entity Type | Individual
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Provider Name | OTIS JEFFREY BATY PNP
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Gender | Male
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 MEDICAL CAMPUS DR STE 207
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City | SUPPLY
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State | NC
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Zip | 28462-4094
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Country | US
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Telephone | 910-755-5066
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Fax |
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Provider Business Mailing Address
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Address Line | 7909 PAWLEYS LN
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City | WILMINGTON
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State | NC
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Zip | 28411-8716
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Country | US
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Telephone | 910-686-7613
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State | NC
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