OrganizationActive
The University of Rhode Island
NPI 1477065118 · General Practice Physician · Kingston, RI
Provider details
- NPI number
- 1477065118
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mouzon Bass, Agent(972) 367-4845
- License
- DO00893 (RI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3 Keaney Road
Suite 1
Kingston, RI 02881
Phone: (972) 367-4845
Approximate (ZIP-level) locationGet directions
Mailing address
5050 Spring Valley Rd
Dallas, TX 75244-3995
Other names (DBA / former)
- Doing business as
- Rhode Island Sports Medicine
Registry dates
- Enumerated
- 2017-11-03
- Last updated
- 2017-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.