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DR. FOSSUM
NPI 1235326026
Urology in Fort Walton Beach, FL

Active since September 26, 2007
914 MAR WALT DR STE B, FORT WALTON BEACH, FL 32547(850) 266-5722(850) 862-8564 Get Directions Write a Review

NPPES record last updated: December 14, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Fossum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. FOSSUM (NPI 1235326026) is a healthcare organization registered as an urology in Fort Walton Beach, Florida and active in the NPI registry since September 2007. The organization lists April Hughes, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1235326026
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameBASIL D. FOSSUM, M.D., F.A.C.S.
Location Address914 MAR WALT DR STE BFort Walton Beach, FL 32547-6706
Mailing Address914b Mar Walt DrFort Walton Beach, FL 32547-6706 · (850) 862-2555 · Fax (850) 862-8564
Phone(850) 266-5722
Fax(850) 862-8564
Organization SubpartNo
Authorized OfficialApril HughesOffice Manager · (850) 226-6572
Enumeration DateSeptember 26, 2007
Last NPPES UpdateDecember 14, 2020
NPPES CertifiedDecember 14, 2020
✔ NPI 1235326026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
914 MAR WALT DR STE B, Fort Walton Beach, FL 32547
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Other Names 1

Doing Business AsDr. Fossum

Other Identifiers 1

OtherME53505FL · Medical License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BASIL D. FOSSUM, M.D. PA
Urology
914 MAR WALT DR STE B
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 226-6572

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Basil D. Fossum, M.D., F.A.C.S.'s NPI number?

The NPI number for Basil D. Fossum, M.D., F.A.C.S. is 1235326026. It was assigned to this organization in the NPPES registry on September 26, 2007. The provider is doing business as Dr. Fossum.

Where is Basil D. Fossum, M.D., F.A.C.S. located?

Basil D. Fossum, M.D., F.A.C.S. is located at 914 Mar Walt Dr Ste B, Fort Walton Beach, FL 32547. The listed phone number is (850) 266-5722.

What is Basil D. Fossum, M.D., F.A.C.S.'s specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

When was this NPI record last updated?

The NPPES record for Basil D. Fossum, M.D., F.A.C.S. was last updated on December 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.