Provider Demographics
NPI:1124076815
Name:WILLIAM M BATCHELOR JR DDS PA
Entity type:Organization
Organization Name:WILLIAM M BATCHELOR JR DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MAC
Authorized Official - Last Name:BATCHELOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-237-3381
Mailing Address - Street 1:2258 NASH ST N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1729
Mailing Address - Country:US
Mailing Address - Phone:252-237-3381
Mailing Address - Fax:252-237-2164
Practice Address - Street 1:2258 NASH ST N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1729
Practice Address - Country:US
Practice Address - Phone:252-237-3381
Practice Address - Fax:252-237-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50681223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011KAMedicaid
8754578OtherUNITED HEALTHCARE
NC011KAOtherBCBS
NC90496OtherBCBS
NC8990496Medicaid
T63874Medicare UPIN
241201BMedicare ID - Type Unspecified
8754578OtherUNITED HEALTHCARE