Provider Demographics
NPI:1346217585
Name:BATSON, JOHN P III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:BATSON
Suffix:III
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 1:300 NEW RIVER PKWY # 37
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-4450
Mailing Address - Country:US
Mailing Address - Phone:843-208-2420
Mailing Address - Fax:843-208-2424
Practice Address - Street 1:300 NEW RIVER PKWY # 37
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-4450
Practice Address - Country:US
Practice Address - Phone:843-208-2420
Practice Address - Fax:843-208-2424
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22310204C00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC223109Medicaid
SC570521956OtherEMPLOYER ID#
SC570521956OtherEMPLOYER ID#
SC223109Medicaid