William Carey University

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WILLIAM CAREY UNIVERSITY

Practice address

710 William Carey Pkwy
Hattiesburg, MS 39401-7842

Phone

(972) 367-4845

NPI assigned

Dec 19, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mouzon Bass III

Title

Administrator/Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• WCU Sports Medicine Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1235601907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 WILLIAM CAREY PKWY",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017842",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM CAREY UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR/AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WCU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather J Wilkes, LCSW
• Robert G Wilkins, MD
• Whitney Wilkinson, FNP-C
• Will'S Way, LLC
• Will'S Way, LLC
• Treenecia Rochelle Williams-Garraway, P-LPC, NCC, NCSC
• Alexesia S. Williams, LPN
• Ann Austin Williams, O. D.
• Ashley Williams
• Baxter Rose Williams, LMSW

• General Practice Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• General Practice Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.