NPI 1104805043 · live from the CMS NPI Registry
Mark Roy Bateman, MD
Ophthalmology in Jackson, TN. National Provider Identifier 1104805043, active.
NPI record
| NPI | 1104805043 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 668 Skyline Dr, Jackson, TN 38301 |
| Practice phone | 731-424-2414 |
| Enumerated | January 10, 2006 |
| Last updated | November 15, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | MD0017889 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.