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NPI Code Detail

MEDICARE: TABOR RENEE BATUG PA-C

MEDICARE: TABOR RENEE BATUG PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA4780SC
2363A00000XPhysician Assistant5682OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881373983
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABOR RENEE BATUG PA-C
Provider Business Mailing Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6192
Country : US
Telephone Number : 580-379-5000
Fax Number : 580-379-5509
Provider Business Practice Location Address
First Line : 101 S PARK LN STE 300
Second Line :
City : ALTUS
State : OK
Zip : 73521-5731
Country : US
Telephone Number : 580-379-6180
Fax Number : 580-379-6189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 01/27/2026

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Directions to “ TABOR RENEE BATUG PA-C” Practice Location

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