Nicholls State Sports Medicine

LBN: Nicholls State University
Nicholls State Sports Medicine is an health care organization with primary practice located at 906 E 1St St , Thibodaux LA 70301-6701. 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. Nicholls State University can be contacted via phone (985) 448-4837, or through Bass, Mouzon via phone 18005559073.

Contact Information

Primary practice address
906 E 1St St Thibodaux LA 70301-6701
Phone: (985) 448-4837
Fax: (972) 367-3451
Website:
Map and Directions
Authorized official contact:
Name: Bass, Mouzon
Phone: 18005559073

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X

Profile Details

NPI number 1861881435
LBN Legal business name Nicholls State University
DBA Doing business as Nicholls State Sports Medicine
Authorized official Bass, Mouzon
Entity Organization
Organization subpart 1 No
Enumeration date Jan 20th, 2015
Last updated Jan 20th, 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.

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