Individual
MR. ANDREW CLYDE BASS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
315 SOUTH SCRIVEN AVE, LIVE OAK, FL 32064
(386) 362-4822
(386) 364-3534
Mailing address
315 SOUTH SCRIVEN AVE, LIVE OAK, FL 32064
(386) 362-4822
(386) 364-3534
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0017754
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16856
BCBS
FL
Enumeration date
01/30/2006
Last updated
07/08/2007
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