MEDICARE: DR. CAMRON JOHN BATEMAN OD

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
1	152W00000X	Optometrist	62232979934	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00400350	OTHER	UT	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1902839905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAMRON JOHN BATEMAN OD

Provider Business Mailing Address
First Line	:	12229 FLINTLOCK WAY
Second Line	:
City	:	HERRIMAN
State	:	UT
Zip	:	84096-3473
Country	:	US
Telephone Number	:	801-554-4286
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 E 400 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2928
Country	:	US
Telephone Number	:	801-328-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/16/2008

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