Organization
RICHIE P BAST MD INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHIE PATTERSON BAST M.D. (OWNER)
92833734802
Entity
Organization
Contact information
Practice address
110 E. 1ST SOUTH, SAINT JOHNS, AZ 85936
(928) 337-4802
Mailing address
PO BOX 2910, SAINT JOHNS, AZ 85936-2910
(928) 337-4802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AZ14854
AZ
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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