Basic Information
| Provider Information | |||||||||
| NPI: | 1265433916 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATEY | ||||||||
| FirstName: | CHARLOTTE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 HILLCREST AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384012509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313886721 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1407 HATCHER LN | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384013535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313812110 | ||||||||
| FaxNumber: | 9313815178 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2005 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 01054183A | IN | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 37915 | TN | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 4068780 | 01 | TN | BLUE CROSS BLUE SHIELD TN | OTHER |