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Individual

JERRY O BATLEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
34 MOUNTAIN BLVD STE 203, WARREN, NJ 07059-2640
(668) 607-2308
(248) 855-5455
Mailing address
7125 ORCHARD LAKE RD, STE 316, WEST BLOOMFIELD, MI 48322-3629
(866) 607-2308
(248) 855-5455

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101231512
VA
208600000X
Surgery Physician
Primary
MD2015-0624
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007313004
VA
05
33883025
NM
Enumeration date
05/22/2006
Last updated
08/11/2021
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