Trevor Jack Batty (NPI# 1558756106, PAC ID# 5193057008) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1558756106 |
| PAC ID by PECOS | 5193057008 |
| Professional Enrollment ID | I20191025002015 |
| Full Name | Trevor Jack Batty |
| Organization Legal Name | STODDARD MEDICAL INC |
| Address |
147 W Chubbuck Rd Chubbuck ID 83202-2314 |
| Phone Number | 2082387546 |
| Gender | M |
| Medical School | ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY |
| Graduation Year | 2015 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 0840341517 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 | 2082387546 | STODDARD MEDICAL INC |
| Organization Legal Name | STODDARD MEDICAL INC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan T Mcculloch | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Earl R Stoddard | Dermatology | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Leslie I Burnside | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Amy L Mckinlay | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Street Address |
147 W CHUBBUCK RD |
| City | CHUBBUCK |
| State | ID |
| Zip | 83202-2314 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan T Mcculloch | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Earl R Stoddard | Dermatology | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Leslie I Burnside | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Amy L Mckinlay | Physician Assistant | Stoddard Medical Inc | 147 W Chubbuck Rd, Chubbuck, ID 83202-2314 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott Bradley Schaffer | Nurse Practitioner | 476 E Chubbuck Rd, Chubbuck, ID 83202-1816 | |
| Brittany Strong | Nurse Practitioner | Need-a-nurse Medical Staffing, LLC | 476 E Chubbuck Rd, Chubbuck, ID 83202-1816 |
| David P Brizzee | Family Medicine | 2010 Flandro Dr, Pocatello, ID 83202-1947 | |
| Nathan J Evans | Chiropractic | 2010 Flandro Dr, Pocatello, ID 83202-1947 | |
| Lavar W Kofoed | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Richard Dallin Boardman | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Daniel G Nielson | Optometry | Lwk, P.C. | 4013 Yellowstone Ave, Suite D, Chubbuck, ID 83202-1984 |
| Sandra L Vollmer | Clinical Social Worker | T Help | 4737 S Afton Pl, Suite A, Chubbuck, ID 83202-2317 |
| Daniel L Traughber | Psychologist, Clinical | T Help | 4737 S Afton Pl, Suite A, Chubbuck, ID 83202-2317 |
| Russell L Vollmer | Clinical Social Worker | T Help | 4737 S Afton Pl, Suite A, Chubbuck, ID 83202-2317 |
| Find all physicians in zip 83202 | |||
| City | CHUBBUCK |
| Zip Code | 83202 |
| Specialty | DERMATOLOGY |
| City + Specialty | CHUBBUCK + DERMATOLOGY |
Please comment or provide details below to improve the information on Trevor Jack Batty.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.