NORTHEASTERN STATE UNIVERSITY SPORTS MEDICINE - NPI 1194198192

Q: What is Northeastern State University's NPI number?

The NPI number for Northeastern State University is 1194198192. It was assigned to this organization in the NPPES registry on November 12, 2015.

Q: What is Northeastern State University's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

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About Northeastern State University Sports Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEASTERN STATE UNIVERSITY SPORTS MEDICINE (NPI 1194198192) is a healthcare organization registered as an orthopaedic surgery in Tahlequah, Oklahoma and active in the NPI registry since November 2015. The organization lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1194198192

Entity TypeOrganization

Primary Taxonomy207X00000X

Legal Business NameNORTHEASTERN STATE UNIVERSITY

Location Address603 N GRAND AVETahlequah, OK 74464-2302

Mailing AddressPo Box 650850, Dept 1011Dallas, TX 75265-0850 · (800) 555-9073 · Fax (972) 367-3452

Phone(918) 444-3921

Fax(972) 367-3451

Organization SubpartNo

Authorized OfficialMouzon BassAgent · (972) 367-4845

Enumeration DateNovember 12, 2015

✔ NPI 1194198192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X

603 N GRAND AVE, Tahlequah, OK 74464

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Other Names 1

Doing Business AsNortheastern State University Sports Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SHANNON RAE SLAYTON ATC, LAT