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General NPI Number Information
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NPI Number | 1962798439
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MISSISSIPPI
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 1848 UNIVERSITY CIRCLE ATHLETIC DEPARTMENT
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City | OXFORD
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State | MS
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Zip | 38677
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Country | US
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Telephone | 662-915-1842
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 819020
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City | DALLAS
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State | TX
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Zip | 75381-9020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR ASSOCIATE AD
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Name | SHANNON SINGLETARY
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Credential | ATC, DPT, CSCS
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Telephone | 662-915-1842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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