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  5. Keith E. Basham PHYSICIAN ASSISTANT
Male or Other

Keith E. Basham PHYSICIAN ASSISTANT

Physician Assistant in Albuquerque, NM(View on Map)

Full Name

Keith Emory Basham PHYSICIAN ASSISTANT

NPI Number

1124329339

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/04/2010

Specialties

(Taxonomies)

Name

Physician Assistant

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Colorado
New Mexico

License Number

3117
PA2011-0057

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 26028
2901 TRANSPORT ST SE

City

Albuquerque
Albuquerque

State

NM
NM

Postal Code

87125-6028
87106-4382

Country

US
US

Telephone Number

N/A
(505) 262-7110

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/17/2024

Provider Address

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