Provider Demographics
NPI:1013922772
Name:BASSI, BARINDER PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARINDER
Middle Name:PAUL
Last Name:BASSI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 S BLISS AVE
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-2512
Mailing Address - Country:US
Mailing Address - Phone:918-207-3780
Mailing Address - Fax:918-207-3781
Practice Address - Street 1:100 S BLISS AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-2512
Practice Address - Country:US
Practice Address - Phone:918-207-3780
Practice Address - Fax:918-207-3781
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-00718213E00000X
KS1200357213E00000X
OK309213E00000X
MO2012019495213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist