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SOUTHEAST MISSOURI STATE UNIVERSITY NPI 1871003301


NPI Information

NPI: 1871003301
Provider Name: SOUTHEAST MISSOURI STATE UNIVERSITY

Doing Business As: SEMO STATE SPORTS MEDICINE

Classification: Physical Medicine & Rehabilitation - 2081S0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
1 UNIVERSITY PLZ # MS 0200
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (972) 367-4845
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SOUTHEAST MISSOURI STATE UNIVERSITY is a sports medicine physical medicine rehabilitation in Cape Girardeau, MO. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. SOUTHEAST MISSOURI STATE UNIVERSITY NPI is 1871003301. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Semo State Sports Medicine.

The provider's business location address is:

1 UNIVERSITY PLZ # MS 0200
CAPE GIRARDEAU, MO
ZIP 63701-710
Phone: (972) 367-4845

The provider's authorized official is Mouzon Bass .
The authorized official title is Agent and has the following contact phone number (972) 367-4845.

The enumeration date for this NPI number is 10/11/2017 and was last updated on 12/17/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12081S0010XPhysical Medicine & RehabilitationSports Medicine2007008844MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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