| Doctor Name: | MR. RAOUL JAY BHATTA |
| NPI Number: | 1215103718 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD.28833 |
| Business Practice Address: | Lyster Army Health Clinic Bldg 301 Andrews Ave Fort Rucker, AL - 363625333 |
| Business Phone Number: | 3342557894 |
| Business Fax Number: | 3342557382 |
| Mailing Address: | Lyster Army Health Clinic, Bldg 301 Andrews Ave FORT RUCKER |
| State: | AL |
| Postal Code: | 363625333 |
| Phone Number: | 3342557894 |
| Fax Number: | 3342557382 |
| NPI Enumeration Date: | 05/05/2008 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD.28833 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |