Muskingum University
Organization Active NPI General Practice Physician · New Concord, OH
NPI 1568029205 · NPPES record last updated Dec 17, 2021
Key facts
- NPI
- 1568029205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- MUSKINGUM UNIVERSITY
- Practice address
- 163 Stormont St
New Concord, OH 43762-1118 - Phone
- (740) 826-8211
- NPI assigned
- May 28, 2019
- Organization subpart
- No
Authorized official
- Name
- Mouzon Bass III
- Title
- Administrator/Agent
- Phone
- (972) 367-4845
Corporate family (same tax ID) 1
Practitioners 2
-
Jailene Ericka Olds, ATC
National Provider Directory
- Tax ID family
- Muskingum Health Center
Locations
163 Stormont St
New Concord, OH 43762
Phone (740) 826-8211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
163 Stormont St
New Concord, OH 43762-1118
Mailing address
15305 Dallas Pkwy Ste 800
Addison, TX 75001-6415
Phone (972) 367-4845
Other names
- Muskingum Sports Medicine
Other providers in New Concord, OH
- Michael Edwin Merritt
- Karen Mihalik
- Amy Dawn Mohler
- Lisa Jo Morris
- Muskingum University
- Jailene Ericka Olds
- William H Overholser
- Jeff A Pattison
- Kent L. Pattison
- Regina Lynn Pennell
All providers in New Concord, OH · General Practice Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.