Doctor Name: | DR. CRAIG B. BASS |
NPI Number: | 1003823956 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | M-4306 |
Business Practice Address: | 250 Bobwhite Ct # 275 Boise, ID - 837066643 |
Business Phone Number: | 2083330200 |
Business Fax Number: | 2083330399 |
Mailing Address: | 250 Bobwhite Ct, # 275 BOISE |
State: | ID |
Postal Code: | 837066643 |
Phone Number: | 2083330200 |
Fax Number: | 2083330399 |
NPI Enumeration Date: | 08/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0122X |
License Number: | M-4306 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Plastic and Reconstructive Surgery |
Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |