Fort Valley State University
NPI #1457737769 in Fort Valley, Georgia
Provider Information
- NPI Number
- 1457737769
- Entity Type
- Organization
- Organization Name
- Fort Valley State University
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Aug 10, 2015
- Last Updated
- Aug 10, 2015
Practice Location
- Address
- 1005 STATE UNIVERSITY DR
- City
- Fort Valley
- State
- Georgia
- ZIP Code
- 31030-4313
- Phone
- (478) 825-6195
Authorized Official
- Name
- MOUZON BASS III
- Title
- AGENT
- Phone
- (972) 367-4845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Sports Medicine — Sports Medicine |
| Internal Medicine |
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