Provider Demographics
NPI:1457600405
Name:BATCHU, VERA (MD)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BATCHU
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 1:8518 GATE HOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916
Mailing Address - Country:US
Mailing Address - Phone:479-441-4000
Mailing Address - Fax:
Practice Address - Street 1:4839 WHITE PINE DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6022
Practice Address - Country:US
Practice Address - Phone:916-382-8500
Practice Address - Fax:916-221-9882
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1457600405Medicaid