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Individual

CHERYL LUCY BASCOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
613 23RD ST STE 430, ASHLAND, KY 41101-2885
(606) 408-8200
(606) 408-6291
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
38583
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000345909
ANTHEM INSURANCE
05
2549148
OH
05
3810028923
WV
05
64093370
KY
Enumeration date
09/16/2006
Last updated
09/06/2024
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