Millikin University

NPI #1164176863 in Decatur, Illinois

Provider Information

NPI Number: 1164176863
Entity Type: Organization
Organization Name: Millikin University
Primary Specialty: Internal Medicine
Enumeration Date: Feb 10, 2022
Last Updated: Feb 10, 2022

Practice Location

Address: 1184 W MAIN ST
City: Decatur
State: Illinois
ZIP Code: 62522-2039
Phone: (972) 367-4845

Authorized Official

Name: MR. MOUZON BASS III
Title: ADMINISTRATOR/AGENT
Phone: (972) 367-4845

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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