Provider Demographics
NPI:1679750541
Name:BATTY, TRENT WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:TRENT
Middle Name:WALTER
Last Name:BATTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 S 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-3301
Mailing Address - Country:US
Mailing Address - Phone:928-428-3122
Mailing Address - Fax:928-428-7917
Practice Address - Street 1:1300 S 20TH AVE
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-3301
Practice Address - Country:US
Practice Address - Phone:928-428-3122
Practice Address - Fax:928-428-7917
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7755A207Q00000X
AZ41253207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine