Nicholas Basham, PA
Nicholas Basham, PA is a Physician Assistant in Fort Campbell, Kentucky. Qualified in 2014, 12 years ago. Practices with Jennie Stuart Medical Center Inc, a 110-clinician group and accepts Medicare assignment. Licensed in Tennessee.
- Years since qualifying
- 12
- Licensed in
- TN
- In the registry since
- 2014
- Specialties on file
- 2
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
650 Joel DrFort Campbell, KY 42223-5318
Phone: (270) 412-5122
Fax: (270) 412-5168
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence PA0000002721 (TN) |
|---|---|
| Surgical Physician Assistant | Taxonomy 363AS0400X |
Record details
| NPI number | 1710301684 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | February 12, 2014 |
| Last updated in NPPES | April 25, 2019 |
| Mailing address | 625 N Riverside Dr, Clarksville, TN 37040-3127 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2014 (12 years in practice) |
| Group practice | Jennie Stuart Medical Center Inc — 110 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Fort Campbell
-
Mr. Terry G Davis, PA
Blanchfield Army Community Hospital 650 Joel Dr, Fort Campbell, KY 42223 · (270) 798-8372
-
Desiree L Johnson, PA-C
650 Joel Dr, Fort Campbell, KY 42223-5318 · (270) 798-8727