Organization · Type 2 NPI

Basil Fossum MD PA

Urology Physician · Fort Walton Beach, FL

NPI number 1184594962 Active

Practice location

914B Mar Walt Dr
Fort Walton Beach, FL 32547-6706

Fax (850) 862-8564

Specialties and licenses

Taxonomy	Code	License
Urology Physician Primary	208800000X	None listed

Urology Physician: 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.

3 other providers at this address

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About NPI 1184594962

Basil Fossum MD PA's National Provider Identifier is 1184594962, issued on Nov 7, 2025. The primary taxonomy on file is Urology Physician (208800000X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Apr 20, 2026.