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General NPI Number Information
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NPI Number | 1770752347
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Entity Type | Organization
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Legal Business Name | JACK BATTIN
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 202 W TEXAS AVE
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City | ARTESIA
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State | NM
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Zip | 88210-2147
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Country | US
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Telephone | 575-746-4832
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Fax | 575-746-9737
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Provider Business Mailing Address
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Address Line | 202 WEST TEXAS AVE.
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City | ARTESIA
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State | NM
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Zip | 88210
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Country | US
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Telephone | 575-746-4832
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Fax | 575-746-9737
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACK BATTIN
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Credential | O.D.
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Telephone | 575-746-4832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | NM220
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License Number State | NM
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