Individual
ETHAN CHRISTOPHER BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-2000
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
35130618
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210218
—
OH
01
—
H564960
MEDICARE-CGS
OH
Enumeration date
04/12/2011
Last updated
09/06/2022
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