Etsu Sports Medicine

LBN: East Tennessee State University
Etsu Sports Medicine is an health care organization with primary practice located at 1081 John Robert Bell Dr Rm W-127, Johnson City TN 37614. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. East Tennessee State University can be contacted via phone (972) 367-4845, or through Bass, Mouzon via phone (972) 367-4845.

Contact Information

Primary practice address
1081 John Robert Bell Dr Rm W-127 Johnson City TN 37614
Phone: (972) 367-4845
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bass, Mouzon
Phone: (972) 367-4845

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1285264531
LBN Legal business name East Tennessee State University
DBA Doing business as Etsu Sports Medicine
Authorized official Bass, Mouzon
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2020
Last updated Dec 17th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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