Individual
HALEY BASFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10040 COUNTY ROAD 48, FAIRHOPE, AL 36532-4520
(251) 220-6780
Mailing address
18307 OUTLOOK DR, LOXLEY, AL 36551-3638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
AL
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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