NPI 1063891158

Missouri Western State University

Organisation Orthopaedic Surgery Physician Saint Joseph, MO

Practice location

Address: 4525 Downs Dr, Saint Joseph, MO 64507-2246
Phone: (816) 271-4597
Fax: (972) 367-3451
Mailing address: PO Box 650850 Dept 1011, Dallas, TX 75265-0850

Authorised official

Name: Mouzon Bass
Title: Agent
Phone: (972) 367-4845

Registered specialties (2)

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X

Other Orthopaedic Surgery providers in Missouri →

Sports Medicine (Orthopaedic Surgery) Physician

Allopathic & Osteopathic Physicians Taxonomy 207XX0005X

Registry record

NPI: 1063891158
Entity type: Organization
NPI issued: 22 May 2015
Record last updated: 22 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.