Provider Demographics
NPI:1841293677
Name:BASSETT, RALPH E (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:E
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 1:14510 W SHUMWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5815
Mailing Address - Country:US
Mailing Address - Phone:623-975-1660
Mailing Address - Fax:623-584-4282
Practice Address - Street 1:14510 W SHUMWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5815
Practice Address - Country:US
Practice Address - Phone:623-975-1660
Practice Address - Fax:623-584-4282
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2023-01-23
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
AZ24954174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020539454OtherSCHALLER ANDERSON HEALTH
AZ020539454OtherHUMANA
AZ020539454OtherSUN HEALTH CORPORATION
AZ397564OtherAHCCCS
AZAZ0899410OtherBLUE CROSS BLUE SHIELD
AZ020539454OtherPACIFICARE
AZ40016859OtherRRB
AZ606061100OtherDEPT OF LABOR-FECA
AZ001829159004OtherUNITED HEALTH CARE
AZ020539454OtherSECURE HORIZONS
AZNA918125Medicaid
AZNA918125Medicaid