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Organization
BAZZANO CLINIC PA
Active
Organization
BAZZANO CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J BAZZANO D.O. (OWNER)
(417) 781-2638
Entity
Organization
Contact information
Practice address
111 E 7TH ST, GALENA, KS 66739-1229
(620) 783-1358
(620) 783-5055
Mailing address
PO BOX 277, GALENA, KS 66739-0277
(620) 783-1358
(620) 783-5055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32305
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080075003
PALMETTO GBA RAILROAD MCR
KS
05
—
100098210A
—
KS
05
—
240387605
—
MO
Enumeration date
11/21/2009
Last updated
08/16/2010
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