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Lindenwood University-Belleville — NPI 1316499155, Belleville, IL | NPI Central

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NPI 1316499155

OrganizationActive

Lindenwood University-Belleville

NPI 1316499155 · Sports Medicine (Orthopaedic Surgery) Physician · Belleville, IL

Provider details

NPI number: 1316499155
Entity type: Organization
Primary specialty: Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
Organization subpart: No
Authorized official: Mouzon Bass, Agent(972) 367-4845
License: 036129925 (IL)

Specialties & taxonomies

Sports Medicine (Orthopaedic Surgery) PhysicianPrimary207XX0005XLicense 036129925 (IL)
Allopathic & Osteopathic Physicians

Practice location

2600 W Main St

Belleville, IL 62226-6651

Phone: (972) 367-4845

Approximate (ZIP-level) locationGet directions

More IL providers

Mailing address

5050 Spring Valley Rd.

Dallas, TX 75244-3909

Other names (DBA / former)

Doing business as: Lindenwood University-Belleville Sports Medicine

Registry dates

Enumerated: 2016-10-27
Last updated: 2016-10-27

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.