Provider Demographics
NPI:1609800119
Name:BATCHELOR, ROBIN L (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:L
Last Name:BATCHELOR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-0419
Mailing Address - Country:US
Mailing Address - Phone:231-627-1438
Mailing Address - Fax:231-627-1471
Practice Address - Street 1:6135 CRESSY ST
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749
Practice Address - Country:US
Practice Address - Phone:231-238-8908
Practice Address - Fax:231-238-4419
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601001014363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
M94990P01Medicare ID - Type Unspecified
S59842Medicare UPIN