Middle Georgia State University Sports Medicine

LBN: Middle Georgia State University
Middle Georgia State University Sports Medicine is an health care organization with primary practice located at 1100 2Nd St Se , Cochran GA 31014-1564. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Middle Georgia State University can be contacted via phone (972) 367-4845, or through Bass, Mouzon via phone (972) 367-4845.

Contact Information

Primary practice address
1100 2Nd St Se Cochran GA 31014-1564
Phone: (972) 367-4845
Fax: (972) 367-3451
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
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X

Profile Details

NPI number 1629449400
LBN Legal business name Middle Georgia State University
DBA Doing business as Middle Georgia State University Sports Medicine
Authorized official Bass, Mouzon
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2015
Last updated Oct 19th, 2015 - about 10 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.

Request for update

Popular Providers