Individual
DR. ORAL EDWARD BASS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2004 W MARLER LN, OZARK, MO 65721-7661
(417) 581-3927
Mailing address
PO BOX 858, OZARK, MO 65721-0858
(417) 581-3927
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2003028770
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015702
PTAN
MO
01
—
1013037365
INDIVIDUAL NPI
MO
05
—
1487825535
—
MO
Enumeration date
03/30/2007
Last updated
09/19/2013
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