Bastidas, Juan Guillermo

Bastidas, Juan Guillermo is an individual health care provider with primary practice located at 613 23Rd St Ste 210 , Ashland KY 41101-2868. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Bastidas, Juan Guillermo can be contacted via phone (606) 326-9847.

Contact Information

Primary practice address
613 23Rd St Ste 210 Ashland KY 41101-2868
Phone: (606) 326-9847
Fax: (606) 324-3418
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD.201742 Louisiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X A115149 California
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 49423 Kentucky

Profile Details

NPI number 1033301080
LBN Legal business name Bastidas, Juan Guillermo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2007
Last updated Jul 21st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033301080 NPPES
Ohio MEDICAID 0193538
Ohio MEDICAID 7100454120

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