Javan S. Bass DPM

NPI 1669601381 - Podiatrist - 213ES0103X

NPI Details
NPI 1669601381
Gender Male
Enumeration Date 07/02/2009
Last Updated 02/23/2010
Entity Type Individual
Active Over 8 years ago
Practice Location
8225 MALL PKWY
LITHONIA GA, 30038-6994, US
Phone (770) 484-9599
Fax
Business Location
302 PROVIDENCE DR
DALLAS GA, 30157-7465, US
Phone (334) 538-1020
Fax
Toxanomy
Taxonomy Code 213ES0103X
License State Pennsylvania
License Number SC006097
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According to our database, Dr. Javan S. Bass DPM NPI is 1669601381, taxonomy code is 213ES0103X and license number is SC006097, license state is located at Pennsylvania. Javan S. Bass DPM physically located at 8225 Mall Pkwy, Lithonia GA, 30038-6994. NPI Number Javan S. Bass DPM has the Individual type.

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1669601381 NPI number is provided on an as is basis without warranty of any kind. 1669601381 is maintained by the National Plan & Provider Enumeration System. The contents of Javan S. Bass DPM are for informational purposes only.