Jacksonville State University
Jacksonville State University is a Sports Medicine (Family Medicine) Physician in Jacksonville, Alabama. Licensed in Alabama. Registered with an NPI since 2016.
- Licensed in
- AL
- In the registry since
- 2016
Practice location Address checks out
700 Pelham Rd NJacksonville, AL 36265-1602
Phone: (256) 782-5369
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Medicine (Family Medicine) Physician (primary) | Taxonomy 207QS0010X · Licence 10954 (AL) |
|---|
Record details
| NPI number | 1548717119 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mouzon Bass — Agent · (972) 367-4845 |
| Other names | Jacksonville State University Sports Medicine |
| NPI enumerated | September 1, 2016 |
| Last updated in NPPES | September 1, 2016 |
| Mailing address | 5050 Spring Valley Rd., Dallas, TX 75244-3909 |