Individual
DOUGLAS BASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2821 N BALLAS RD STE C15, SAINT LOUIS, MO 63131-2300
(618) 578-8667
(314) 983-9650
Mailing address
4105 ENDICOTT CT, SWANSEA, IL 62226-8210
(618) 578-8667
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.005775
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
135.000901
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
2018037270
MO
Other
Enumeration date
01/07/2016
Last updated
11/27/2023
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