Provider Demographics
NPI:1225094816
Name:JOHN P BASKETT DC PA
Entity Type:Organization
Organization Name:JOHN P BASKETT DC PA
Other - Org Name:PUTNAM COUNTY CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-325-8305
Mailing Address - Street 1:3800 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3902
Mailing Address - Country:US
Mailing Address - Phone:386-325-8305
Mailing Address - Fax:386-325-8304
Practice Address - Street 1:3800 SAINT JOHNS AVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3902
Practice Address - Country:US
Practice Address - Phone:386-325-8305
Practice Address - Fax:386-325-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2010-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22888Medicare ID - Type Unspecified