Provider Demographics
NPI:1669446654
Name:BASSANI, FRANCIS J SR (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:J
Last Name:BASSANI
Suffix:SR
Gender:M
Credentials:DO
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Mailing Address - Street 1:647 N BROAD STREET EXT
Mailing Address - Street 2:WOLF CREEK MEDICAL ASSOCIATES
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4604
Mailing Address - Country:US
Mailing Address - Phone:724-450-7004
Mailing Address - Fax:724-450-7013
Practice Address - Street 1:647 N BROAD STREET EXT
Practice Address - Street 2:WOLF CREEK MEDICAL ASSOCIATES
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4604
Practice Address - Country:US
Practice Address - Phone:724-450-7004
Practice Address - Fax:724-450-7013
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2010-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS 009460-L207V00000X
PAOS009460L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016436220006Medicaid
PA0016436220006Medicaid