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General NPI Number Information
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NPI Number | 1508847609
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Entity Type | Individual
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Provider Name | GREGORY D BASYE P.A.-C.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 2000 W BETHANY HOME RD PHOENIX BAPTIST HOSPITAL
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City | PHOENIX
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State | AZ
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Zip | 85015-2443
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Country | US
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Telephone | 602-246-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 3107 E VERMONT DR
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City | GILBERT
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State | AZ
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Zip | 85297
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Country | US
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Telephone | 480-558-0797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MED-PAC-LIC-131929
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2177
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License Number State | AZ
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