Lindenwood University

Organization Active NPI Orthopaedic Surgery Physician · Saint Charles, MO

NPI 1831646397 · NPPES record last updated Sep 7, 2016

Key facts

NPI
1831646397
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
2013027435 (MO)
Legal business name
LINDENWOOD UNIVERSITY
Practice address
209 S Kingshighway St
Saint Charles, MO 63301-1693
Phone
(636) 949-2000
NPI assigned
Sep 1, 2016
Organization subpart
No

Authorized official

Name
Mouzon Bass III
Title
Agent
Phone
(972) 367-4845

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lindenwood University (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X 2013027435 MO Yes

Addresses

Primary practice location

209 S Kingshighway St
Saint Charles, MO 63301-1693

Mailing address

5050 Spring Valley Rd.
Dallas, TX 75244-3909

Other names

  • Lindenwood University Sports Medicine Doing business as

Other providers in Saint Charles, MO

All providers in Saint Charles, MO · Orthopaedic Surgery Physician in Missouri

Sources for this page

Verify at the official NPI Registry.