Healthcare Provider Details

I. General information

NPI: 1831288307
Provider Name (Legal Business Name): EROL BASKURT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 MORRIS PL NE
WASHINGTON DC
20002-5221
US

IV. Provider business mailing address

13737 NOEL RD STE 1600
DALLAS TX
75240-1374
US

V. Phone/Fax

Practice location:
  • Phone: 303-933-8270
  • Fax:
Mailing address:
  • Phone: 303-933-8270
  • Fax: 214-712-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2001026669
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number2001026669
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101234733
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: