Provider Demographics
NPI:1326100348
Name:BATTERTON, THOMAS DAVIES (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DAVIES
Last Name:BATTERTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 JOHN F KENNEDY BLVD
Mailing Address - Street 2:#1213
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1440
Mailing Address - Country:US
Mailing Address - Phone:215-568-0884
Mailing Address - Fax:
Practice Address - Street 1:1900 JOHN F KENNEDY BLVD
Practice Address - Street 2:#1213
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1440
Practice Address - Country:US
Practice Address - Phone:215-568-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006820E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB32601Medicare UPIN