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NPI Code Detail

MEDICARE: JOSEPH EDWARD BASS M.D.

MEDICARE: JOSEPH EDWARD BASS M.D.
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
12085R0202XDiagnostic Radiology Physician23720ALAL
22085R0202XDiagnostic Radiology Physician2017022028MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194799338
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH EDWARD BASS M.D.
Provider Business Mailing Address
First Line : 6000 HOSPITAL DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6887
Country : US
Telephone Number : 573-248-5304
Fax Number : 573-248-5311
Provider Business Practice Location Address
First Line : 6000 HOSPITAL DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6887
Country : US
Telephone Number : 573-248-5304
Fax Number : 573-248-5311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/21/2022

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Directions to “ JOSEPH EDWARD BASS M.D.” Practice Location

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