Individual
SHAD T BATEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-2980
(208) 785-3504
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-2980
(208) 785-3504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-1720
ID
Other
Enumeration date
07/10/2019
Last updated
04/23/2025
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