Individual
JAMES JEFFREY BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 202-2484
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 426-2108
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R2C49
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010066255
RAILROAD MEDICARE
MO
01
—
100719
HEALTHLINK
MO
05
—
201810504
—
MO
01
—
9476
BLUE CROSS BLUE SHIELD
MO
Enumeration date
11/02/2005
Last updated
06/10/2025
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