Individual
DR. JACOB BASAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2014018054
MO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
DR.0062061
CO
Other
Enumeration date
06/17/2014
Last updated
08/27/2019
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