Brevard College

Organization Active NPI Sports Medicine (Family Medicine) Physician · Brevard, NC

NPI 1831848860 · NPPES record last updated Mar 18, 2022

Key facts

NPI
1831848860
Entity type
Organization (NPI type 2)
Primary specialty
Sports Medicine (Family Medicine) Physician 207QS0010X
Legal business name
BREVARD COLLEGE
Practice address
1 Brevard College Dr
Brevard, NC 28712-4283
Phone
(972) 367-4845
NPI assigned
Mar 18, 2022
Organization subpart
No

Authorized official

Name
Mr. Mouzon Bass
Title
Administrator/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
Brevard College (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QS0010X Yes

Addresses

Primary practice location

1 Brevard College Dr
Brevard, NC 28712-4283

Mailing address

15305 Dallas Pkwy Ste 800
Addison, TX 75001-6415
Phone (972) 367-4845

Other names

  • BREVARD COLLEGE ATHLETICS Doing business as

Other providers in Brevard, NC

All providers in Brevard, NC · Sports Medicine (Family Medicine) Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.