Provider Demographics
NPI:1922184647
Name:BATEMAN, SCOTT N (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:N
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5710A207Y00000X, 207YS0123X
332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No332S00000XSuppliersHearing Aid Equipment
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY116034100Medicaid
WY303780OtherBLUECROSS BLUESHIELD
WY116034100Medicaid
WY303780OtherBLUECROSS BLUESHIELD