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Organization
MILLIKIN UNIVERSITY
Active
Organization
MILLIKIN UNIVERSITY
Active
Other names
Millikin University Athletics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1184 W MAIN ST, DECATUR, IL 62522-2039
(972) 367-4845
Mailing address
15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415
(972) 367-4845
(972) 367-3451
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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