Bacastow, David Wesley
Bacastow, David Wesley is an individual health care provider with primary practice located at 1765 Old West Broad St , Athens GA 30606-2853. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Bacastow, David Wesley can be contacted via phone (706) 549-1663.Contact Information
Primary practice address
1765 Old West Broad St
Athens GA 30606-2853
Phone: (706) 549-1663
Fax: (706) 546-8792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 25939 | Georgia |
Profile Details
| NPI number | 1770541617 |
|---|---|
| LBN Legal business name | Bacastow, David Wesley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2006 |
| Last updated | Mar 8th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770541617 | NPPES |
| Georgia | Other | 10572795 | CAQH |
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