Baskett, Dirk Kenneth

Baskett, Dirk Kenneth is an individual health care provider with primary practice located at 840 N 4Th E , Mountain Home ID 83647-2166. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Baskett, Dirk Kenneth can be contacted via phone (208) 587-1850.

Contact Information

Primary practice address
840 N 4Th E Mountain Home ID 83647-2166
Phone: (208) 587-1850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-2374 Idaho

Profile Details

NPI number 1841920220
LBN Legal business name Baskett, Dirk Kenneth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2022
Last updated Dec 23rd, 2022 - about 3 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841920220 NPPES
Oregon MEDICAID 500812528

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