# DR. JACOB BASAK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376957381
- **Gender:** Man
- **Credential:** M.D., PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 2014018054 | MO | — |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | DR.0062061 | CO | Yes |

## Other

- **Enumeration date:** 06/17/2014
- **Last updated:** 08/27/2019