Provider Demographics
NPI:1285603811
Name:BATTE, WILLIAM GRANVILLE JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GRANVILLE
Last Name:BATTE
Suffix:JR
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 1:2700 UNIVERSITY SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5513
Mailing Address - Country:US
Mailing Address - Phone:813-253-2721
Mailing Address - Fax:813-977-3720
Practice Address - Street 1:2700 UNIVERSITY SQUARE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-253-2721
Practice Address - Fax:813-977-3720
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010523852085R0202X
FLME1335062085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10126061Medicaid
FL100241200Medicaid
KYP00915982OtherRAILROAD MEDICARE
VA005851H04Medicare ID - Type Unspecified
KYP400036057Medicare PIN
VA10126061Medicaid
KYP400036056Medicare PIN