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Organization

TUSKEGEE UNIVERSITY

Active
Other names
Tuskegee University Sports Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization

Contact information

Practice address
1200 W MONTGOMERY RD, SECOND FLOOR LOGAN HALL, TUSKEGEE INSTITUTE, AL 36088-1923
(334) 724-4545
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
00008637
AL

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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