Provider Demographics
NPI:1801813696
Name:BATTAGLIA, TAMMY MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:MICHELLE
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:MICHELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:918-744-2553
Mailing Address - Fax:918-744-3482
Practice Address - Street 1:1923 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6520
Practice Address - Country:US
Practice Address - Phone:918-744-2553
Practice Address - Fax:918-744-3482
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22244207ZP0102X
KS04-28070207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1572Medicaid
OK1572Medicaid
OKH45004Medicare UPIN
KSP00274867Medicare ID - Type UnspecifiedKS RAILROAD MEDICARE