Provider Demographics
NPI:1124162680
Name:BATTS, GERALD T JR (LDO)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:T
Last Name:BATTS
Suffix:JR
Gender:M
Credentials:LDO
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Mailing Address - Street 1:518 GREENVILLE BLVD SE
Mailing Address - Street 2:SUITE F
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6740
Mailing Address - Country:US
Mailing Address - Phone:252-756-8834
Mailing Address - Fax:252-756-8814
Practice Address - Street 1:518 GREENVILLE BLVD SE
Practice Address - Street 2:SUITE F
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6740
Practice Address - Country:US
Practice Address - Phone:252-756-8834
Practice Address - Fax:252-756-8814
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC646156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician