Basic Information
| Provider Information | |||||||||
| NPI: | 1982699906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATICH | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 LEROY ST | ||||||||
| Address2: | |||||||||
| City: | POTSDAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136761799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152653300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 80 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136171450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157143170 | ||||||||
| FaxNumber: | 3157143176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 21794 | WV | N | Other Service Providers | Specialist | 207V00000X | 175660 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 146416 | 01 | UNITED MINE WORKERS | OTHER | 3810001404 | 05 | WV | MEDICAID | 21794 | 01 | WV | UPPER OHIO VALLEY HEALTH | OTHER | 264495 | 01 | CARELINK | OTHER | 175660 | 01 | NY | NYS LICENSE | OTHER | 2540558 | 05 | OH | MEDICAID | 7200274 | 01 | WV | CIGNA | OTHER | 7626136 | 01 | AETNA | OTHER | 845896 | 01 | FIRST HEALTH | OTHER |