Provider Demographics
NPI:1013991892
Name:BASSETT, TIMOTHY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DAVID
Last Name:BASSETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 COMMONS NORTH LOOP
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3577
Mailing Address - Country:US
Mailing Address - Phone:205-750-0447
Mailing Address - Fax:205-750-0276
Practice Address - Street 1:1781 COMMONS NORTH LOOP
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3577
Practice Address - Country:US
Practice Address - Phone:205-750-0447
Practice Address - Fax:205-750-0276
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00018074207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51527770OtherBCBS
AL051527770Medicaid
051527770Medicare ID - Type Unspecified
F82446Medicare UPIN