Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Augusta University

Organization Sports Medicine (Family Medicine) Physician · NPI 1215711155

Augusta University provides Sports Medicine (Family Medicine) Physician services in Augusta, Georgia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1120 15th St # B132
Augusta, GA 30912-0004
Phone: (972) 367-4845
Fax: (972) 367-3451
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1215711155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names Augusta University Athletics
NPI enumeratedAugust 22, 2023
Last updated in NPPESAugust 22, 2023
Certification dateAugust 22, 2023
Mailing address15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415

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