Bassham, Thomas W.
Bassham, Thomas W. is an individual health care provider with primary practice located at 2488 E 81St St Ste 290 , Tulsa OK 74137-4265. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Bassham, Thomas W. can be contacted via phone (918) 494-2665.Contact Information
Primary practice address
2488 E 81St St Ste 290
Tulsa OK 74137-4265
Phone: (918) 494-2665
Fax: (918) 927-3201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 1371 | Oklahoma |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1371 | Oklahoma |
Profile Details
| NPI number | 1588647002 |
|---|---|
| LBN Legal business name | Bassham, Thomas W. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2005 |
| Last updated | May 26th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588647002 | NPPES |
| Oklahoma | MEDICAID | 100180730A |
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