Provider Demographics
NPI:1700041993
Name:BATTISTE, TIFFINI (DO)
Entity Type:Individual
Prefix:
First Name:TIFFINI
Middle Name:
Last Name:BATTISTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TIFFINI
Other - Middle Name:
Other - Last Name:FLICKINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:929 N SAINT FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3821
Mailing Address - Country:US
Mailing Address - Phone:316-268-5757
Mailing Address - Fax:316-291-7496
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-5757
Practice Address - Fax:316-291-7496
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-37063207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110990055OtherMEDICARE
200295320AOtherOK MEDICAID
KS201070860BMedicaid