Individual
RICHARD D BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
332 S MAIN ST, LEITCHFIELD, KY 42754-1428
(270) 971-1388
(270) 297-7066
Mailing address
112 CEDAR RIDGE LN, LEITCHFIELD, KY 42754-8002
(270) 971-1388
(270) 297-7066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007397
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12436388
CAQH
KY
Enumeration date
04/12/2012
Last updated
04/11/2024
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