| Doctor Name: | DR. MICHAEL T. BASHFORD |
| NPI Number: | 1114989373 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | K7243 |
| Business Practice Address: | 81msgs/sgcg 301 Fisher Street, Rm 1a132 Keesler Afb, MS - 39534 |
| Business Phone Number: | 2283776393 |
| Business Fax Number: | |
| Mailing Address: | 5908 Wooded Acres Rd, VANCLEAVE |
| State: | MS |
| Postal Code: | 395657263 |
| Phone Number: | 2283776393 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207SG0201X |
| License Number: | K7243 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Medical Genetics |
| Taxonomy Specialization: | Clinical Genetics (M.D.) |
| Taxonomy Definition: | A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |