Organization
UNIVERSITY OF ARKANSAS AT MONTICELLO
Active
Other names
UAM Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
663 UNIVERSITY DRIVE, MONTICELLO, AR 71656
(870) 460-1058
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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