Organization
BASIL D. FOSSUM, M.D., F.A.C.S.
Active
Other names
Dr. Fossum
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL HUGHES (OFFICE MANAGER)
(850) 226-6572
Entity
Organization
Contact information
Practice address
914 MAR WALT DR STE B, FORT WALTON BEACH, FL 32547-6706
(850) 266-5722
(850) 862-8564
Mailing address
914B MAR WALT DR, FORT WALTON BEACH, FL 32547-6706
(850) 862-2555
(850) 862-8564
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME53505
MEDICAL LICENSE
FL
Enumeration date
09/26/2007
Last updated
12/14/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up