Southern Virginia University
NPI #1528654159 in Buena Vista, Virginia
Provider Information
- NPI Number
- 1528654159
- Entity Type
- Organization
- Organization Name
- Southern Virginia University
- Primary Specialty
- Pediatrics - Pediatric Allergy/Immunology
- Enumeration Date
- Dec 17, 2020
- Last Updated
- Dec 17, 2021
Practice Location
- Address
- 1 UNIVERSITY HILL DR
- City
- Buena Vista
- State
- Virginia
- ZIP Code
- 24416-3038
- Phone
- (540) 261-8414
Authorized Official
- Name
- MOUZON BASS III
- Title
- ADMINISTRATOR/AGENT
- Phone
- (972) 367-4845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Pediatric Allergy/Immunology — Pediatric Allergy/Immunology |
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