Bass, Clayton A

Bass, Clayton A is an individual health care provider with primary practice located at 5475 S 500 E , Ogden UT 84405-6905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bass, Clayton A can be contacted via phone (801) 463-7415.

Contact Information

Primary practice address
5475 S 500 E Ogden UT 84405-6905
Phone: (801) 463-7415
Fax: (801) 463-7341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 045167 Georgia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 6068769-1205 Utah
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 13154 Mississippi

Profile Details

NPI number 1972598506
LBN Legal business name Bass, Clayton A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jul 9th, 2009 - about 15 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 1972598506 NPPES
Georgia MEDICAID 000784924D
Georgia MEDICAID 06559318
Georgia Other 52755548-002
Georgia MEDICAID 1490261

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