Oklahoma Wesleyan University

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3219 Issued in OK

Legal business name

OKLAHOMA WESLEYAN UNIVERSITY

Doing business as

OKWU Sports Medicine

Practice address

2201 Silver Lake Rd
Bartlesville, OK 74006-6233

Phone

(972) 367-4845

NPI assigned

Sep 15, 2017

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

Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• OKWU Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505433600000",
    "number": "1427577923",
    "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": "2201 SILVER LAKE RD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740066233",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA WESLEYAN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OKWU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Oklahoma Cancer Specialists and Research Institute LLC
• Oklahoma CVS Pharmacy, L.L.C.
• Oklahoma Oncology and Hematology, P.C.
• Oklahoma Sports Science Institute Inc
• Oklahoma Treatment Services LLC
• Michael Okoro
• Geri Lynn Oliveira, L.AC, DIPL. O.M
• Robert D Oliver, MD
• Sophia Olsen, M.S., CCC-SLP
• Open-Sided MRI of Bartlesville , LLC

• Family Medicine Physician in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; 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.