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

Middle Georgia State University

Organization Family Medicine Physician · NPI 1629449400

Middle Georgia State University is a Family Medicine Physician in Cochran, Georgia. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2

Practice location Address checks out

1100 2nd St SE
Cochran, GA 31014-1564
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

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

Record details

NPI number1629449400
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names Middle Georgia State University Sports Medicine
NPI enumeratedOctober 19, 2015
Last updated in NPPESOctober 19, 2015
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995

Other providers in Cochran