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General NPI Number Information
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NPI Number | 1649353533
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Entity Type | Individual
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Provider Name | JAMES MARTIN BASHAW CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 915 SW 79TH ST
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City | LAWTON
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State | OK
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Zip | 73505-6427
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Country | US
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Telephone | 405-926-7348
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Fax |
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Provider Business Mailing Address
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Address Line | 915 SW 79TH ST
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City | LAWTON
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State | OK
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Zip | 73505-6427
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Country | US
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Telephone | 405-926-7348
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R0075945
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License Number State | OK
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