Basham Clinic, P.a.

Organization Active NPI Family Medicine Physician · Eureka, KS

NPI 1124407341 · NPPES record last updated May 20, 2015

Key facts

NPI
1124407341
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
04-28069 (KS)
Legal business name
BASHAM CLINIC, P.A.
Practice address
100 E 16TH St
Eureka, KS 67045-1067
Phone
(620) 750-0099
Fax
(620) 583-6397
NPI assigned
May 20, 2015
Organization subpart
No

Authorized official

Name
Mark A Basham, MD
Title
Owner
Phone
(620) 750-0099

National Provider Directory

Locations

100 E 16th St
Eureka, KS 67045
Phone (620) 583-7451

800 N Main St
Eureka, KS 67045
Phone (620) 583-5200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 04-28069 KS Yes

Addresses

Primary practice location

100 E 16TH St
Eureka, KS 67045-1067

Mailing address

PO Box 63
Andover, KS 67002-0063
Phone (316) 633-4413

Other providers in Eureka, KS

All providers in Eureka, KS · Family Medicine Physician in Kansas

Sources for this page

Verify at the official NPI Registry.