Individual provider · NPI-1

Jack B Basil, MD

Obstetrics & Gynecology, Gynecologic Oncology · Cincinnati, OH

NPI number1073505525

StatusActive

Last updated in NPPESSep 17, 2014

Details

NPI: 1073505525
Entity type: Individual (NPI-1)
Name: Jack B Basil
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Aug 19, 2005
Last updated: Sep 17, 2014

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207VX0201X	Obstetrics & Gynecology, Gynecologic Oncology	35084002	OH	Yes

Practice location

3219 Clifton Ave
Suite 100
Cincinnati, OH 45220-3027

Phone 513-862-1888 · Fax 513-862-3616

Mailing address

Po Box 635063
Cincinnati, OH 45263-0001

Phone 513-891-1006

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