NICHOLAS BASHAM PA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1710301684- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 650 JOEL DR, FORT CAMPBELL, KY, 422235318
- Phone
- (270) 412-5122
- Fax
- (270) 412-5168
Specialties & Taxonomies
Physician Assistant, Surgical
Physician Assistant
Primary License: TN #PA0000002721