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NPI Code Detail

MEDICARE: DR. TIMOTHY M BASSETT D.C.

MEDICARE:  DR. TIMOTHY M BASSETT  D.C.
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
1111N00000XChiropractorCH0007652FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
155835OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1487696712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY M BASSETT D.C.
Provider Business Mailing Address
First Line : 201 FLORIDA PL SE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5812
Country : US
Telephone Number : 850-301-0900
Fax Number : 850-301-0606
Provider Business Practice Location Address
First Line : 201 FLORIDA PL SE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5812
Country : US
Telephone Number : 850-301-0900
Fax Number : 850-301-0606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 07/21/2022

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