Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Copiah Lincoln Community College

Organization Family Medicine Physician · NPI 1548659097

Copiah Lincoln Community College is a Family Medicine Physician in Wesson, Mississippi. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2
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Practice location Address checks out

1028 Jc Redd Dr
Wesson, MS 39191-5020
Phone: (601) 643-8481
Fax: (972) 367-3451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X

Record details

NPI number1548659097
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (800) 555-9073
Other names Colin Sports Medicine
NPI enumeratedJanuary 21, 2015
Last updated in NPPESJanuary 21, 2015
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995

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