Provider Demographics
NPI:1083719785
Name:BATTLES, MICHELE A (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:BATTLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 POPLAR AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4823
Mailing Address - Country:US
Mailing Address - Phone:901-683-5500
Mailing Address - Fax:901-683-2900
Practice Address - Street 1:6401 POPLAR AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4823
Practice Address - Country:US
Practice Address - Phone:901-683-5500
Practice Address - Fax:901-683-2900
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN033879207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3853483Medicaid
TN3165329OtherBCBS
TN3853483Medicaid
TN3853482Medicare PIN