Provider Demographics
NPI:1841318250
Name:BASSETT, HAROLD (DO)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:BASSETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 STUDENT HEALTH CENTER
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802
Mailing Address - Country:US
Mailing Address - Phone:814-863-8624
Mailing Address - Fax:814-863-8464
Practice Address - Street 1:319 STUDENT HEALTH CENTER
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802
Practice Address - Country:US
Practice Address - Phone:814-863-8624
Practice Address - Fax:814-863-8464
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005498-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABA465708OtherBLUE SHIELD
PAE14126Medicare UPIN