Individual
DR. BRIAN E. BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 767-2273
Mailing address
1059 BARTON DR, FORDLAND, MO 65652-7350
(417) 767-2273
(417) 767-4054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R7P13
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203173505
—
MO
Enumeration date
11/20/2006
Last updated
03/12/2025
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