Provider Demographics
NPI:1619275534
Name:BATCHELOR, MONIQUE NICOLE (O D)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:NICOLE
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-1915
Mailing Address - Country:US
Mailing Address - Phone:770-969-5976
Mailing Address - Fax:770-969-6140
Practice Address - Street 1:4002 STONE MOUNTAIN HWY STE 100
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-3977
Practice Address - Country:US
Practice Address - Phone:770-985-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist