Provider Demographics
NPI:1114517034
Name:BASSETT, PHILIP (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:BASSETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S MEDICAL CENTER DR RM 170
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8723
Mailing Address - Country:US
Mailing Address - Phone:435-251-2420
Mailing Address - Fax:385-297-2375
Practice Address - Street 1:600 S MEDICAL CENTER DR RM 170
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8723
Practice Address - Country:US
Practice Address - Phone:435-251-2420
Practice Address - Fax:385-297-2375
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8103948-17011835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care