# BASDEN FAMILY PRACTICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245498567
- **Authorized official:** DR. CHERYL BASDEN D.O. (OWNER)
- **Authorized official phone:** (404) 362-0282

## Contact information

- **Practice address:** 4940 GOVERNORS DR, SUITE 203, FOREST PARK, GA 30297-2186
- **Practice address phone:** (404) 362-0282
- **Practice address fax:** (404) 362-0285
- **Mailing address:** 4940 GOVERNORS DR, SUITE 203, FOREST PARK, GA 30297-2186
- **Mailing address phone:** (404) 362-0282
- **Mailing address fax:** (404) 362-0285

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 030951 | GA | Yes |

## Other

- **Enumeration date:** 05/23/2008
- **Last updated:** 05/23/2008