Individual
STEPHEN J BAZZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
111 E 7TH ST, GALENA, KS 66739-1229
(620) 783-1358
(620) 783-5055
Mailing address
PO BOX 277, 111 E 7TH ST, GALENA, KS 66739
(620) 783-1358
(620) 783-5055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14599
KS
207Q00000X
Family Medicine Physician
32305
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080075003
PALMETTO GBA RAILROAD MCR
KS
05
—
100098210A
—
KS
05
—
240387613
—
MO
Enumeration date
08/11/2006
Last updated
08/16/2010
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