Jacques J Bataille, O.D.
Individual provider Active NPI Optometrist · Austintown, OH
NPI 1376658765 · NPPES record last updated Jun 4, 2008
Key facts
- NPI
- 1376658765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4528 (OH)
- Practice address
- 6001 Mahoning Ave
Austintown, OH 44515-2227 - Phone
- (330) 270-0013
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4528 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacques Bataille, O.D., Inc. | Optometrist | Current | Accepting new patients |
Locations
6001 Mahoning Ave
Youngstown, OH 44515
Phone (330) 270-0006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4528 | OH | Yes |
Addresses
Primary practice location
6001 Mahoning Ave
Austintown, OH 44515-2227
Mailing address
6001 Mahoning Ave
Austintown, OH 44515-2227
Other providers in Austintown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.