Individual
DR. JEFFREY BASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2874 N CARSON ST, SUITE 200, CARSON CITY, NV 89706-0251
(775) 445-7170
(775) 883-0959
Mailing address
PO BOX 4540, CARSON CITY, NV 89702-4540
(775) 445-7170
(775) 883-0959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8079
NV
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
8079
NV
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
8079
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013094
—
NV
01
—
110218907
RAILROAD MEDICARE #
NV
01
—
NV0116
BCBS PROVIDER #
NV
Enumeration date
01/26/2007
Last updated
01/11/2023
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