Individual
DR. DERWOOD E BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2371 NE STEPHENS ST, SUITE 200, ROSEBURG, OR 97470-1372
(541) 672-8533
(541) 672-4993
Mailing address
2371 NE STEPHENS ST, SUITE 200, ROSEBURG, OR 97470-1372
(541) 672-8533
(541) 672-4993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO171270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165772
—
OR
Enumeration date
04/12/2007
Last updated
07/17/2015
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