Central State University

NPI #1508244641 in Wilberforce, Ohio

Provider Information

NPI Number: 1508244641
Entity Type: Organization
Organization Name: Central State University
Primary Specialty: Family Medicine
Enumeration Date: May 8, 2015
Last Updated: May 8, 2015

Practice Location

Address: 1400 BRUSH ROW RD
City: Wilberforce
State: Ohio
ZIP Code: 45384-5800
Phone: (937) 925-3748

Authorized Official

Name: MOUZON BASS III
Title: AGENT
Phone: (972) 367-4845

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Sports Medicine — Sports Medicine	207QS0010X
Family Medicine	207Q00000X	Primary

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Organizations

Provider Name	Specialty	City
Central State University	Family Medicine	Wilberforce	AI Deep Dive

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