Individual
JESSE BRYAN BASFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1108 ROSS CLARK CIR, EMERGENCY DEPARTMENT, DOTHAN, AL 36301
(334) 793-8111
Mailing address
1108 ROSS CLARK CIR, EMERGENCY DEPARTMENT, DOTHAN, AL 36301
(334) 793-8111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36180
AL
Other
Enumeration date
04/09/2012
Last updated
01/22/2019
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