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Organization

PATRIOT ANESTHESIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES MARTIN BASHAW CRNA (PRESIDENT)
(405) 926-7348
Entity
Organization

Contact information

Practice address
1800 W UNIVERSITY BLVD, DURANT, OK 74701-3006
(405) 926-7348
(405) 207-9956
Mailing address
35907 E COUNTY ROAD 1600, PAULS VALLEY, OK 73075-9070
(405) 926-7348
(405) 207-9956

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
75945
OK

Other

Enumeration date
11/15/2010
Last updated
06/22/2011
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