Provider Demographics
NPI:1942280888
Name:BATSON, JOHN PATTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATTON
Last Name:BATSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4867
Mailing Address - Country:US
Mailing Address - Phone:479-567-5152
Mailing Address - Fax:479-567-5155
Practice Address - Street 1:1212 W 2ND ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-4867
Practice Address - Country:US
Practice Address - Phone:479-567-5152
Practice Address - Fax:479-567-5155
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3537204E00000X
TN8580122300000X
GADN0145741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist