Organization
FORT VALLEY STATE UNIVERSITY
Active
Other names
FVSUSports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1005 STATE UNIVERSITY DR, FORT VALLEY, GA 31030-4313
(478) 825-6195
Mailing address
PO BOX 650850, DALLAS, TX 75265-0850
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us