Provider Demographics
NPI:1578754487
Name:SCOTT N BATEMAN, MD
Entity Type:Organization
Organization Name:SCOTT N BATEMAN, MD
Other - Org Name:SHERIDAN EAR NOSE & THROAT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:N
Authorized Official - Last Name:BATEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-672-0290
Mailing Address - Street 1:330 W DOW ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3829
Mailing Address - Country:US
Mailing Address - Phone:307-672-0290
Mailing Address - Fax:307-672-0884
Practice Address - Street 1:330 W DOW ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3829
Practice Address - Country:US
Practice Address - Phone:307-672-0290
Practice Address - Fax:307-672-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5710A207Y00000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY01033001OtherBLUE CROSS AND BLUE SHIELD
WY112709801Medicaid
WY112709801Medicaid