Provider Demographics
NPI:1417181751
Name:KEVIN N BATTERBEE D.O. LLC
Entity Type:Organization
Organization Name:KEVIN N BATTERBEE D.O. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:NORBERT
Authorized Official - Last Name:BATTERBEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-465-1178
Mailing Address - Street 1:13255 HONEY RUN WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2087
Mailing Address - Country:US
Mailing Address - Phone:719-465-1178
Mailing Address - Fax:719-358-7638
Practice Address - Street 1:13255 HONEY RUN WAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2087
Practice Address - Country:US
Practice Address - Phone:719-465-1178
Practice Address - Fax:719-358-7638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO473352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427112572OtherMEDICARE NPI, INDIVIDUAL
MI4477122Medicaid
H07589Medicare UPIN