MEDICARE: OSCAR A BATISTA M.D.

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	207RG0100X	Gastroenterology Physician	59769661205	UT

General Provider Information

NPI Number	:	1962443465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR A BATISTA M.D.

Provider Business Mailing Address
First Line	:	6360 S 3000 E
Second Line	:	STE 220
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	801-944-3188
Fax Number	:	901-944-3186

Provider Business Practice Location Address
First Line	:	6360 S 3000 E
Second Line	:	STE 310
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	801-944-3144
Fax Number	:	901-944-3186

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	12/23/2014

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