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DR. EDWARD KING BASS M.D.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1205811262
Individual Registrant:DR. EDWARD KING BASS M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1014 W FRANKLIN ST SYLVESTER, GA 31791-1978 US
Tel: 229-776-2965 Fax: 229-776-4452
Tel: 229-776-2965 Fax: 229-776-4452
Contact information for business:
PO BOX 561 SYLVESTER, GA 31791-0561 US
Tel: 229-776-2965 Fax: 229-776-4452
Tel: 229-776-2965 Fax: 229-776-4452
Registration Information:
NPI: 1205811262
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | 049270 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00892196D | GA | 05 | |
| 00892196C | GA | 05 |
