1841293677 NPI number — DR. RALPH E BASSETT M.D.

Table of content: DR. RALPH E BASSETT M.D. (NPI 1841293677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841293677 NPI number — DR. RALPH E BASSETT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BASSETT
Provider First Name:
RALPH
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841293677
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/17/2006
NPI Reactivation Date:
03/31/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14510 W SHUMWAY DR STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUN CITY WEST
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85375-5815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-975-1660
Provider Business Mailing Address Fax Number:
623-584-4282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14510 W SHUMWAY DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUN CITY WEST
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85375-5815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-975-1660
Provider Business Practice Location Address Fax Number:
623-584-4282
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  24954 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: 24954 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 020539454 . This is a "SCHALLER ANDERSON HEALTH" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 020539454 . This is a "HUMANA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 020539454 . This is a "SUN HEALTH CORPORATION" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 397564 . This is a "AHCCCS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0899410 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 020539454 . This is a "PACIFICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 40016859 . This is a "RRB" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 606061100 . This is a "DEPT OF LABOR-FECA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 001829159004 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 020539454 . This is a "SECURE HORIZONS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: NA918125 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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