Provider Demographics
NPI:1316011075
Name:BATTLES, STEPHEN M (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:BATTLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 THORNDALE DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4817
Mailing Address - Country:US
Mailing Address - Phone:330-678-3455
Mailing Address - Fax:
Practice Address - Street 1:9318 STATE ROUTE 14
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5224
Practice Address - Country:US
Practice Address - Phone:330-626-3455
Practice Address - Fax:330-626-4189
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0520510Medicaid
OH0520510Medicaid
OHBA0524481Medicare ID - Type Unspecified