| Doctor Name: | OTIS JEFFREY BATY |
| NPI Number: | 1700850658 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PNP |
| License Number: | |
| Business Practice Address: | 20 Medical Campus Dr Ste 207 Supply, NC - 284624094 |
| Business Phone Number: | 9107555066 |
| Business Fax Number: | |
| Mailing Address: | 7909 Pawleys Ln, WILMINGTON |
| State: | NC |
| Postal Code: | 284118716 |
| Phone Number: | 9106867613 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |