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

State of Louisiana

Organization Sports Medicine (Family Medicine) Physician · NPI 1578950028

State of Louisiana is a Sports Medicine (Family Medicine) Physician in Hammond, Louisiana. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2

Practice location Address checks out

548 Western Ave
Hammond, LA 70402-0001
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
Orthopaedic Surgery Physician Taxonomy 207X00000X

Record details

NPI number1578950028
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names Southeastern Louisiana Sports Medicine
NPI enumeratedApril 22, 2015
Last updated in NPPESApril 22, 2015
Mailing addressPo Box 650850, Dept 1011, Dallas, TX 75265-0850

Other providers in Hammond