Southwestern Oklahoma State University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SOUTHWESTERN OKLAHOMA STATE UNIVERSITY

Practice address

100 Campus Dr
Weatherford, OK 73096-3001

Phone

(972) 367-4845

NPI assigned

Mar 6, 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

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• SWOSU Sports Medicine Doing business as

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1235631128",
    "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": "100 CAMPUS DR",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963001",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SWOSU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Sitton
• Aaron Skinner, PTA
• Cherilen Slagell, LPN
• Catheryn Ann Smith, M.ED. LPC
• Southwesten Oklahoma State University Training Room
• Southwestern Oklahoma State University
• Southwestern Sports & Industrial Rehab Clinc Inc
• Amy Elizabeth Sparks, B.S.W.
• Crystal Speights
• Constance Spivey

• Orthopaedic Surgery Physician in Weatherford, OK
• Providers in Weatherford, OK by specialty
• Orthopaedic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.