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NPI Code Detail

MEDICARE: JON EDWARD BASLER

MEDICARE: JON EDWARD BASLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174M00000XVeterinarian215AK

General Provider Information

NPI Number : 1346670601
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON EDWARD BASLER
Provider Business Mailing Address
First Line : 2036 E NORTHERN LIGHTS BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-4101
Country : US
Telephone Number : 907-274-5623
Fax Number : 907-272-9114
Provider Business Practice Location Address
First Line : 2036 E NORTHERN LIGHTS BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-4101
Country : US
Telephone Number : 907-274-5623
Fax Number : 907-272-9114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2013
Last Update Date : 11/22/2013

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Directions to “ JON EDWARD BASLER ” Practice Location

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