Individual
DR. STEVEN R BASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
502 MAIN ST, GUTHRIE CENTER, IA 50115-1425
(641) 332-2365
(641) 332-2370
Mailing address
502 MAIN, GUTHRIE CENTER, IA 50115
(641) 332-2365
(641) 332-2370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22362
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179945
—
IA
05
—
0293423
—
IA
01
—
080023739
RAILROAD MEDICARE
—
01
—
10821
MIDLANDS
—
01
—
17994
BLUE CROSS BLUE SHIELD OF
—
01
—
179945
FIRST ADMINISTRATORS
—
01
—
22362
IOWA LICENSE NUMBER
—
01
—
IA0105
JOHN DEERE
—
Enumeration date
03/17/2006
Last updated
12/23/2009
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