Derek Russell Bass, DO

NPI #1184201584 in Kingsport, Tennessee

Provider Information

NPI Number: 1184201584
Entity Type: Individual
Name: Derek Russell Bass, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: DO
Enumeration Date: Mar 24, 2021
Last Updated: Mar 24, 2021

Practice Location

Address: 130 W RAVINE RD STE 9C
City: Kingsport
State: Tennessee
ZIP Code: 37660-3837
Phone: (423) 224-3292

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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