Provider Demographics
NPI:1073592218
Name:BASCO, DENNIS GEARY (DC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GEARY
Last Name:BASCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CAMP RD
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-9131
Mailing Address - Country:US
Mailing Address - Phone:870-248-3300
Mailing Address - Fax:870-248-3300
Practice Address - Street 1:302 CAMP RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-9131
Practice Address - Country:US
Practice Address - Phone:870-248-3300
Practice Address - Fax:870-248-3300
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59673OtherBLUE CROSS BLUE SHIELD
ART83084Medicare UPIN
AR59673OtherBLUE CROSS BLUE SHIELD